the World has doubled the number of caesarean sections, and within 15 years almost. 2015 has been born, therefore, every fifth child in this way. This Figures to scientists at the world Congress of the International Association for gynecology and obstetrics in Rio de Janeiro.

While many women in lower income countries and regions, the part is not life-saving surgery, it is applied in many countries to middle and higher income too often, the experts. Also in Germany, the number of caesarean sections increased according to the analysis, since 2000, steadily: it was in 2015, with only 30 percent.

In a series of articles in The journal “The Lancet” to describe scientists, extent, and consequences of, as well as possible interventions against the development, which they refer to as the “caesarean section epidemic”.

“pregnancy and birth are normal processes, and can in most cases safely,” stresses the Belgian gynecologist Marleen Temmerman, the research at the Aga Khan University in Kenya and the Ghent University in Belgium. The strong increase in medically unnecessary C-sections, especially in the more prosperous countries of concern is worrying because of the risks that are associated with the intervention for both mother and child.

“In cases where there are complications, save lives, caesarean sections, and we need to improve their accessibility in poorer regions, so that they are universally available,” summarizes Temmerman in a message. “But we should not use them excessively.”

experts estimate that up to 15 percent of all births, a cesarean section is medically indicated, because the health or life of the mother or child are at risk. But at this number there is also criticism. “This Rate is not the goal of a leader,” says Wolfgang Henrich, Director of the clinic for Obstetrics at the Charité in Berlin. The initial situation in individual countries is very different and not comparable. “In Germany and other Western countries, there are significantly more cases of good reasons for a cesarean section.” The are, for example, the rising age of women at birth, the proportion of pregnancies after artificial insemination and the associated problems such as multiple pregnancies, the increase in Obesity, high blood pressure or Diabetes and a very high need for security for the child. A “caesarean section avoidance of hysteria” is not helping.

the number of caesarean sections is associated with the economic development of a country closely, is also evidenced by the analysis of the researchers in the first of the three studies. The Team of doctors Ties Boerma from the University of Manitoba (Canada) had data from the world health organization (WHO) and the children’s Fund of the United Nations (UNICEF) out of 169 countries analyzed. So you covered 98.4 percent of the births in the world.

The analysis showed that the proportion between 2000 and 2015 is, on average, increased each year by almost four per cent from twelve to 21 percent. The development was very different: While in southern Africa, less than five percent of the children by caesarean section on the world to come, the Rate in some Parts of Latin America, with almost 60 per cent. In almost all countries with low rates of caesarean section, the health system was inadequate.

From the 6.2 million probably unnecessary interventions would be carried out half in China and Brazil – and, in particular, in the case of pregnancies with a low risk or in women who have already had a C-section. Within these countries, there are large differences. Thus, the Rate fluctuations in China depending on the Region, between four and 62 percent. In Brazil was marked, in addition, a phenomenon, which is observed worldwide: in particular, highly educated women would bring children by caesarean. However, the country has already taken several measures to reduce the Rate, as Brazil’s Minister of health, Gilberto stresses Magalhães Occhi in a comment on the study.

observed How physicians Boerma and his Team, were caesarean sections carried out in addition to Latin America, especially in North America and Western Europe frequently. Also in Germany, the number of the Emperor has cuts since 2000, almost doubled: from 15 percent in 1990 to more than 30 percent in 2017, as the Federal Statistical office. The worldwide rise in the caesarean section rate, the scientists bring, among other things, in connection with the fact that around the globe more births were in health facilities instead of one, and that caesarean sections were more frequent.

the consequences of The interventions studied by a Team led by the birth of a specialist, Jane Sandall from King’s College in London. The researchers combed through for a medical article from the period between 1993 and 2018. The result Occurred in the case of birth complications, increase a cesarean first of all, the chance of Survival of mother and child. In addition, the likelihood of incontinence or a pathological reduction of the pelvic organs could be reduced after the birth.

there were, However, associated with the procedure, even short – term and long-term risks. Overall, an Emperor meant cutting a more complicated healing process for the mother, stress the authors. The associated scarring of the uterus could cause bleeding as well as in subsequent pregnancies to abnormal development of the placenta, pregnancies, such as in the fallopian tubes, or too Dead – and premature births. In addition, there is more and more evidence that babies cut in an Emperor of a different hormonal, bacterial and medical environment could take, which impact on your health.

But why the Emperor is increasing the rate cut? Some additional reasons for the third article in “The Lancet”. Women would follow, therefore, often out of fear of pain or of the Birth, such as pelvic floor damage, incontinence, and less of sexuality fulfilled after a cesarean section questions, write to the authors to Physician Ana Pilar Betrán by the WHO.

to address these Worries, the scientist, among other things, to examine the effect of relaxation training, birth preparation courses, lectures, and brochures. Basically, most women would want a natural birth. Key problems, which ultimately led to an engagement, were more often found in economic and organizational factors in the health system, says Franka Cadée, the President of the International midwives Association (ICM) in a further comment. You advocated to strengthen the Position of midwives.

in fact, there is evidence that births under the supervision of midwives in birth centres, as well as with the continuous support of the birth ended process, less frequently in the Emperor, noting the study of E. Betrán by the WHO. According to new WHO recommendations focus on the role of the midwife at birth in the foreground.

to advise the German expert Henrich considers it important that intensive for a vaginal birth. “But it is equally important to respect the desire of a woman after a caesarean section, and to accept, ultimately.” In addition, be overlooked in the discussion is often the case that the vaginal birth are associated risks. Different than a caesarean section, doctors would have to inform about it prior to birth. “The one-sided education about the risks of a caesarean section and the possible consequence of damage to a Mature woman, is unfair.”

Medical consequences, researchers in a study from “the Lancet”,-gravity: In the journal “PNAS”, they demonstrate the results of your comparison of naturally and by caesarean section debound mice. In the case of the Former, died three hours after birth in several regions of the brain significantly less cells than those who were born by caesarean section. And: the Latter were also heavier. The conclusion of the researchers: “The birth process can affect the development of the nerves. This can lead to lasting effects on brain function and behavior.“


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