High Cesarean Section Rates in Latin America, a Reflection of a Different Approach to Labor?

Eghon Guzman^1*, Jack Ludmir², Mark DeFrancesco³

¹Hospital Dr. Sotero del Rio, Integramedica Bupa, Santiago, Chile.
²Department of Obstetrics and Gynecology Perelman, School of Medicine at the University of Pennsylvania and Pennsylvania Hospital, Philadelphia, PA, USA.
³Department of Obstetrics and Gynecology, University of Connecticut, Farmington, CT, USA.

DOI: 10.4236/ojog.2015.58062                

Abstract

Increasing rates of cesarean section, as high as 50% in some countries in Latin America, compared with the US and the rest of the world, demand a closer analysis of its causes and implications. The significant morbidity for both mother and baby associated with cesarean section requires immediate action from national and international societies to confront the situation with specific solutions, including patient education. We recommend a consensus meeting of Latin American ACOG (American College of Obstetricians and Gynecologists) section members to address the issue and to consider adopting guidelines based on evidence and reflecting the realities of the countries involved.

Keywords

Cesarean Section Rates

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Gibbons, L., Belizan, J.M., Lauer, J.A., Betran, A.P., Merialdi, M. and Althabe, F. (2010) The Global Numbers and Costs of Additionally Needed and Unnecessary Cesarean Sections Performed per Year: Overuse as a Barrier to Universal Coverage. World Health Report 2010, Background Paper, 30.
[2]	Gibbons, L., Belizan, J.M., Lauer, J.A., Betran, A.P., Merialdi, M. and Althabe, F. (2012) Inequities in the Use of Cesarean Section Deliveries in the World. American Journal of Obstetrics & Gynecology, 206, e1-e19. http://dx.doi.org/10.1016/j.ajog.2012.02.026
[3]	Guzman, E. (2012) Epidemiological Profile of Caesarean Section in Chile in the Decade 2000-2010. Medwave, 12, e5331.
[4]	Safe Prevention of the Primary Cesarean Section Delivery (2014) Obstetric Care Consensus No. 1. American College of Obstetricians and Gynecologists. Obstetrics & Gynecology, 123, 693-711. http://dx.doi.org/10.1097/01.AOG.0000444441.04111.1d
[5]	Cesarean Delivery on Maternal Request (2013) Committee Opinion No. 559. American College of Obstetricians and Gynecologists. Obstetrics & Gynecology, 121, 904-907. http://dx.doi.org/10.1097/01.AOG.0000428647.67925.d3
[6]	Many, A., Helpman, L., Vilnai, Y., Kupfermic, M.J., Lessing, J.B. and Dolberg, S. (2006) Neonatal Respiratory Morbidity after Elective Cesarean Section. The Journal of Maternal-Fetal & Neonatal Medicine, 19, 775-778. http://dx.doi.org/10.1080/14767050500333868
[7]	Vaginal Birth after Previous Cesarean Delivery (2010) Practice Bulletin No. 115. American College of Obstetricians and Gynecologists. Obstetrics & Gynecology, 116, 450-463. http://dx.doi.org/10.1097/AOG.0b013e3181eeb251