The Dominican Republic is the global leader in C-sections, with the World Health Organization reporting in 2015 that 56% of all births were by C-section. The number is expected to be even higher this year. In the Dominican Republic, C-sections appear to be the birth procedure of choice, rather than the exception. The study revealed back then that 42% of all births in public hospitals were by C-section, while 87% of births in private clinics were by C-section.
In most countries abroad, C-sections are traditionally reserved for circumstances that include prolonged labor, placenta abnormalities, cord prolapse, distress of the fetus, certain diseases and if the baby is in an abnormal position. Globally, medical professionals estimate that these conditions occur in 10 to 15% of births.
In the Dominican Republic, nevertheless, doctors are increasingly recommending C-sections. As a result, young physicians are losing confidence in their ability to assist in vaginal births. Moreover, women have also increasingly requested the C-sections due to prior negative experiences with natural births, fear of labor pain or damage to their bodies or concerns about future sexual function.
However, recent studies confirm that there are no benefits of employing the procedure without a medical justification and indeed women and babies can die from complications from C-sections, especially when a medical facility is under-resourced and staff is under-trained.
New studies organized for the International Federation of Gynecology and Obstetrics World Congress presented recently in Brazil indicate that the use of C-sections is highest in the Dominican Republic, Brazil, Egypt, Turkey and Venezuela, accounting for more than half of all births there. Rates of C-sections have increased the most sharply in South Asia, where they accounted for 7% of births in 2000. Since then, the rate in Asia has risen to more than 18 percent of births in 2015.
The findings of the compilations of research indicate that C-sections continue to be overused in North America, where rates grew from 24% to 32% during that time; in Western Europe, with rates of 20% in 2000 and 26% in 2015; and in Latin America and the Caribbean, where rates jumped 32% to 44%.
Low- and middle-income countries saw the greatest disparity the use of C-sections, where wealthy women were six times more likely to have one than the poorest of those populations. The procedure is 1.6 times more likely to take place in a private institution rather than a public one, perhaps due to persistent shortages of staff and facilities in rural and vulnerable regions.
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El Nacional
15 October 2018
