While the USA saw more than a quarter of all births performed by C-section, some states used the procedure more than twice as often as others.
While c-sections can undoubtedly be a life-saving procedure, a new series of three papers reveals the surgery is being dangerously overused in middle- and high-income countries.
The new study, based on data collected from World Health Organization and UNICEF, does not explain this dramatic increase in C-section births in some countries. "The large increases in C-section use - mostly in richer settings for non-medical purposes - are concerning because of the associated risks for women and children", said Series lead Marleen Temmerman from Aga Khan University in Kenya and Ghent University.
They said it can be a life-saving intervention for women and newborns when complications occur, such as bleeding, foetal distress, hypertensive disease, and babies in abnormal position, but the surgery is not without risk for mother and child, and is associated with complications in future births. They said that while 10-15% of live births require C-section, most countries exceed this level.
Scientists have identified 15 countries where more than 40 percent of babies are born by caesarean section.
Dominican Republic had the highest proportion (58.1 per cent), followed by Brazil and Egypt (both 55.5 per cent), and Turkey (53.1 per cent). Rates have increased the most sharply in South Asia, where C-sections accounted for 7 percent of births in 2000 - an underused rate - but have since risen to more than 18 percent of births in 2015.
But in close to a quarter of nations surveyed, C-section use is significantly lower than average.
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Looking at trends in Brazil and China where there is high use of C-section, the researchers found that many were in low-risk pregnancies, in women who were well-educated, and in women who had previously had a C-section.
The caesarean section, or C-section, is a surgical procedure that sees the baby delivered through a surgical incision in the mother's abdomen, rather than through the vaginal canal. "Short-term risks of C-section include altered immune development, an increased likelihood of allergy, atopy and asthma, and reduced intestinal gut microbiome diversity".
Compared to vaginal births, C-sections can actually come with a higher chance of complications, a more hard recovery process and more risks during subsequent pregnancies, according to the report.
"The medical profession on its own can not reverse this trend", Prof. "Joint actions with governmental bodies, the health care insurance industry, and women's groups are urgently needed to stop unnecessary C-sections and enable women and families to be confident of receiving the most appropriate obstetric care for their individual circumstances".
As such, the researchers note how important it is for women to understand the serious risks of getting c-sections and why it is important to opt for it only when necessary.
"Cédric Grouchka, member of the College of the French High Authority of Health, speaks of "downward stabilization" and makes a distinction between "caesareans performed in a hurry, either after a delivery that goes wrong or during work - which correspond to 60% of the total in France - caesareans scheduled for medical reasons (40%) and those programmed for a non-medical reason, at the request of women", which he estimates to" less than 1% ". The situation has led gynecologists to question this "epidemic", as reported in a report published Friday in the British scientific journal The Lancet.
"To ensure this happens we need to give midwives the time to sit and discuss a woman's options for the birth of her baby".