What Are the Most Common Reasons for a C-Section?

The World Health Organization's warning line for cesarean delivery is 15%. The cesarean delivery rate in the United States and Britain is below the warning line, and Japan's is only 7%. China's total cesarean delivery rate is 46.5%, which is more than three times the world's warning line. According to 2010 data from the well-known medical journal "The Lancet", 25% of cesarean sections in China are not due to medical needs, that is, 5 million cesarean sections can be delivered naturally every year.

Chinese cesarean section

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The World Health Organization's warning line for cesarean delivery is 15%. The cesarean delivery rate in the United States and Britain is below the warning line, and Japan's is only 7%. China's total cesarean delivery rate is 46.5%, which is more than three times the world's warning line. According to 2010 data from the famous medical journal The Lancet, 25% of China's

In 2010, 16 million babies were born in China, of which almost half were cesarean sections. In the Chinese literature, the proportion of cesarean sections in China is between 36% and 58%, and this number was still below 5% in the 1980s. Why has cesarean section become the first choice of most people in the past few decades? A new review article published in the British Journal of Obstetrics and Gynecology (BJOG) clearly states that China must work to curb the increasing rate of cesarean operations.

The article states: China has one of the highest cesarean delivery rates in the world. In 2010, 16 million babies were born, of which almost half were cesarean sections. Although specific numbers have not been determined, in the Chinese literature, the proportion of cesarean sections in China ranges from 36% to 58%. However, in the 1980s, the cesarean delivery rate was less than 5% and until 1990, the cesarean delivery rate did not exceed 10%. ^[2]

Such a high rate of cesarean section in China may be caused by three aspects: the structure of the obstetric care system, the encouragement of hospital doctors and other staff, and the preferences of patient customs.

Some aspects related to the Chinese obstetric care system and hospital factors have led to increased cesarean delivery. These aspects include:

High total production quantity. Managing large numbers of births with limited medical resources may lead to higher cesarean delivery rates.

Financial incentives can also lead to higher cesarean delivery rates than vaginal deliveries. Financial incentives include coverage of neonatal insurance, doctor and hospital income.

Public hospitals in China have few employees and are controlled by the government. In China, there is an average of 1.5 nurses or midwives per 1,000 people; in the UK there are 9.8 nurses or midwives per 1,000 people. Compared to vaginal delivery, cesarean section requires less nursing time.

The level of obstetricians and gynecologists varies, with less than 2% of doctors completing master's or doctoral level training.

Many doctors' performance salaries are based on the number of patients received and their hospitalization fees. Caesarean section surgery is more expensive than vaginal delivery, so these stimuli can lead doctors to choose a cesarean section.

In analyzing cesarean delivery rates in China, the preferences of pregnant women are also important factors. The authors point out that people under the one-child policy may have over-perfect expectations for childbirth outcomes, and that pregnant women and doctors may find the benefits of cesarean section more than insufficient. Fear of uncontrollable pain on the bed, epidural anesthesia, nursing assistance or home support all reinforce this expectation.

However, the current approach may soon be changed because in November 2013, China's one-child policy was loosened, and the government encouraged couples to have a second child. More repeated cesarean sections can change both risk and return.

Susan Hellerstein, assistant professor of obstetrics and gynecology at Brigham and Women's Hospital at Harvard Medical School and co-author of the study, said: "Since the 1990s, the rate of cesarean section in China has been less than 10% Soaring to more than 50% of women choose cesarean section to give birth. This phenomenon is likely to improve in the future, and we must encourage vaginal births by reforming certain aspects of the Chinese obstetric care system. Whether to reduce the rate of cesarean section Whatever efforts we make, we must take safety and effectiveness into consideration and ensure the health of pregnant and perinatal women, which is very important in contemporary China. "

Mike, associate editor of the British Journal of Gynecology. According to Mike Marsh, "This review article reveals the underlying reasons for the very high cesarean delivery rate in China. The article clarifies the structure of the health care system, hospitals and pregnant women's preferences as the three leading causes of extremely high cesarean delivery. The key factor. The factors identified in this article that affect cesarean delivery are likely to exist in other countries as well. "

China's high cesarean delivery rate is an unquestionable fact, and the analysis of causes by foreign experts is also reasonable. As the public, knowing about childbirth and choosing the most suitable delivery method is important for both pregnant women and babies, because childbirth is risky. ^[2]

The proportion of cesarean section in China is far higher than the normal level. The potential dangers and long-term negative effects have caused the attention of relevant parties. The competent health department has also included the proportion of cesarean section in the hospital's assessment indicators, but this still does not control the cesarean section. The trend of excessive production ratio.

The evaluation of production indicators should be used as the objective basis for cesarean delivery. The doctors of a certain Maternal and Child Health Hospital in Anhui comprehensively scored the status of the fetus, the birth canal, and the psychological factors of the mother, and informed the mother and family based on the score, and recommended that they perform a delivery or cesarean section.

"Let the mothers and their families have sufficient right to know. After being informed of the risks and benefits of the surgery, their choices will be more rational. The families of the mothers are more convinced by doctors, and they rarely send births that change their minds when they are born." Chen Lei said .

In order to relieve the maternal fear and tension of labor, some new techniques for analgesic delivery and water delivery should be introduced. "Analgesic childbirth can alleviate maternal pain, and it is very psychologically helpful for many women. Many people dare not go through labor because of psychological stress. If doctors tell them that they can give birth to their children within the limit of pain that can be tolerated through technical assistance, The mothers will have a lot of stability in their hearts, and it will help smooth natural delivery. "Chen Ling said. ("Half-moon Talk", No. 12, 2012, reporter Bao Xiaojing) ^[3]