London: The number of babies born in India through caesarean section increased from 9% in 2005-6 to 18.5% in 2015-16, according to a series of three papers published in The Lancet journal, which also found that C-section use almost doubled worldwide between 2000 and 2015.
While the surgery is still unavailable for many women and children in low-income countries and regions, the procedure is overused in many middle-and high-income settings, said researchers, including those from Ghent University in Belgium.
In the ten countries with the highest number of births in 2010-2015 period, there were large differences in caesarean section or C-section use between regions. For instance, differences between provinces in China ranged from 4% to 62%, and inter-state differences in India ranged from 7% to 49%.
Globally, C-section use has increased by 3.7% each year between 2000-2015 — rising from 12% of live births (16 million of 131.9 million) in 2000, to 21% of live births (29.7 million of 140.6 million) in 2015, researchers said.
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In India, C-section use went up from 9% of births in 2005-6 to 18.5% in 2015-16, the research found.
C-section is a life-saving intervention for women and newborns when complications occur, such as bleeding, foetal distress, hypertensive disease, and babies in abnormal position.
Risks involved
However, the surgery is not without risk for mother and child, and is associated with complications in future births, researchers said. It is estimated that 10-15% of births medically require a C-section due to complications, suggesting that average C-section use should lie between these levels.
In at least 15 countries, C-section use exceeds 40%, researchers said.
The South Asia region has seen the most rapid increase in use (6.1% per year), with C-section being underused in 2000 but being overused by 2015 (increasing from 7.2% of births via C-section to 18.1%).
Improvements have been slow across sub-Saharan Africa (around 2% per year), where C-section use has remained low, increasing from 3% to 4.1% of births in West and Central Africa, and from 4.6% to 6.2% in Eastern and Southern Africa.
“Given the increasing use of C-section, even when medically not required, there is a crucial need to understand the health effects on women and children,” said Professor Jane Sandall from King’s College London.