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Local efforts can stem the increasing unnecessary cesarean sections
Date:7/26/2011

Caesarean section rates are steadily increasing globally. Requiring two doctors to agree that a Caesarean section is the best way to deliver a baby, rather than just needing one opinion, providing internal feedback to doctors on the number of operations performed and seeking support from local opinion leaders may reduce the use of this procedure. For low-risk pregnancies, nurse-led relaxation classes for women with a fear or anxiety of childbirth and birth preparation classes for mothers may decrease caesarean sections.

On the other hand, providing prenatal education and support programs, computer patient decision-aids, decision-aid booklets and intensive group therapy to women have not been shown to decrease Caesarean sections effectively. Likewise, insurance reform, legislative changes, external feedback to doctors on their performance and training of public health nurses to provide mode of delivery information in childbirth classes do not decrease caesarean section rates.

These were the findings of a systematic review carried out by researchers in Thailand and Australia and published in The Cochrane Library.

"Around the world more and more women are opting to deliver their babies by a Cesarean section rather than have the discomfort and perceived greater risk of a standard vaginal delivery," says study leader Suthit Khunpradit, who works in the department of Obstetrics and Gynaecology at Lamphun Hospital, in Thailand. He points out that while reported Caesarean section rates vary, studies have shown that in England, Scotland, Norway, Finland, Sweden and Denmark Caesarean section rates rose from around 4% to 5% in 1970 to 20% to 22% in 2001. Furthermore, in 1997 up to 40% of women in Chile opted for a Cesarean section and current figures show that 46.2% of deliveries in China are by Caesarean section.

"In 1985 an expert panel of the World Health Organization suggested that you could expect up to 15% of women to benefit from a C
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Contact: Amy Molnar
healthnews@wiley.com
Wiley-Blackwell
Source:Eurekalert

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