Caesarean sections should only be performed when medically necessary: WHO

The World Health Organization (WHO) on Friday called for careful use of caesarean delivery, saying that it should only be performed when medically necessary.

Caesarean section is one of the most common surgeries in the world, with rates continuing to rise, particularly in high- and middle-income countries.

WHO said in a statement that although caesarean section can save lives, it is often performed without medical need, putting women and their babies at-risk of short- and long-term health problems.

According to WHO, the international healthcare community has considered the "ideal rate" for caesarean sections to be between 10 to 15 percent since 1985.

However, new studies revealed that when caesarean section rates rise towards 10 percent across a population, the number of maternal and newborn deaths decreases. But when the rate goes above 10 percent, there is no evidence that mortality rates improve.

The UN health agency noted the effects of caesarean section on maternal and newborn outcomes such as stillbirths or morbidities like birth asphyxia are still unknown. More research on the impact of caesarean section on women's psychological and social well-being is still needed.

Meanwhile, due to their increased cost, high rates of unnecessary caesarean sections can pull resources away from other services in overloaded and weak health systems.

WHO said the lack of a standardized internationally-accepted classification system to monitor and compare caesarean section in a consistent and action-oriented manner is one of the factors that has hindered a better understanding of this trend.

WHO proposed adopting the Robson classification as an internationally applicable caesarean section classification system.

The Robson system classifies all women admitted for delivery into one of 10 groups based on characteristics that are easily identifiable, such as number of previous pregnancies, whether the baby comes head first, gestational age, previous uterine scars, number of babies and how labor started.

WHO said using this system would facilitate comparison and analysis of caesarean rates within and between different facilities and across countries and regions.

Marleen Temmerman, Director of WHO's Department of Reproductive Health and Research urged the healthcare community and decision-makers to reflect on these conclusions and put them into practice at the earliest opportunity. Endit