More babies are born by C-section (Cesarean section) today than ever before, says the Society of Obstetricians and Gynaecologists of Canada. The Society adds that the numbers continue to rise (1).

Apart from placing mothers at raised risks during childbirth and subsequent pregnancies, these figures are placing an excessive burden on the nation’s healthcare system, the Society claims.

Canadian doctors and pregnant mothers should opt for C-sections only when medically necessary, the Society urges.

Dr. Guylaine Lefebvre, President of the Society of Obstetricians and Gynaecologists of Canada, said “While the individual risk for a woman having a C-section is very small, the rising rate is certainly a concern. We fear that there may be an emerging trend towards more scheduled childbirth and routine intervention. We need to be sure that C-sections are not driven by convenience, that interventions are medically indicated, and that the safety of a woman and her baby are the driving factors in these decisions.”

There are several reasons for the rise in the number of C-sections, most notably the recent increase in obesity rates, as well as the trend for women to delay pregnancy until later in life. The society says there are other less clearly understood factors, such as the current shortage of maternity care providers, as well as the role of changing the patient and physician attitudes about intervention during childbirth.

In 1993 17.6% of all Canadian births were by C-section, in 2006 the figure stood at 26.3%, and continues to go up. This is a concerning trend for the future, says the Society, especially in one of the safest places in the world to give birth.

For a low-risk childbirth that is progressing normally, a mother who undergoes C-section needs much longer to recover, compared to a natural birth. She is also at significantly greater risk of infection, bleeding, scarring, chronic pelvic pain, and damage to the intestines and bladder.

A mother who has a C-section is much more likely to require C-sections in subsequent pregnancies – she also faces greater risks during her subsequent pregnancies.

According to a study carried out by the Canadian Perinatal Surveillance System in 2007, elective C-sections carry a higher risk of anesthetic complications, major infections, obstetrical wound, and cardiac arrest. The researchers also found that elective C-section increased a woman’s risk of having to have a hysterectomy due to bleeding (2).

Dr. André Lalonde, the Society’s Executive Vice-President, said “These additional C-sections place excess burden on a maternity care system that is already facing a shortage of obstetricians and other health professionals.”

The Society of Obstetricians and Gynaecologists of Canada is actively working to provide continuing education for Canadian healthcare professionals on best practices relating to Cesarean section. In addition, the group is seeking collaboration and support from its government and health partners to further explore the root causes of these rising rates, to identify potential solutions, and to properly assess the implications for the safety of childbirth in this country. www.sogc.org

References

(1) Canadian Institute for Health Information
Giving Birth in Canada: Regional Trends From 2001 – 2002 to 2005 – 2006.
Click here to view article online (PDF)

(2) CMAJ
Maternal mortality and severe morbidity associated with low-risk planned Cesarean delivery versus planned vaginal delivery at term
Click here to view article online (PDF)

Written by Christian Nordqvist