Caesarean section is the most popular operation in obstetrics of the 21st century

One of the most often performed surgical procedures in contemporary obstetrics is the Caesarean section. To deliver their babies safely, many women today choose to have this surgery or are required to do so. It was formerly considered a last resort, but for millions of families worldwide, it is now a standard aspect of childbirth.

Caesarean sections are now much safer than they were in the past thanks to improvements in surgical techniques and medical technology. Because of this, more women and their doctors feel comfortable using this technique in cases where vaginal delivery is not the best option or when complications arise.

Significant concerns concerning the causes of the increase, the advantages, and possible dangers of Caesarean sections are raised by this surge in popularity. It’s essential to comprehend these elements in order to make wise choices regarding childbirth.

How the statistics of caesarean sections have changed over the past hundred years

A caesarean section was a "piecemeal" procedure in the USSR in the 1920s because of the high rate of surgical and postoperative complications. The discovery and widespread use of antibiotics in the 1930s and 1940s led to the addition of indications for surgical intervention during childbirth; however, the percentage of births resulting in cesarean sections did not surpass 1%.

This number did not alter until the late 1980s because physicians were still extremely wary of performing this procedure because they thought it would increase the rate of maternal death.

At that time, the goal of birth outcomes in our nation was not to preserve the life of the fetus, whereas in the West, specialized perinatal clinics were established with the express purpose of doing just that. Summaries show that between 1940 and 1958, the average frequency of cesarean sections performed in the USA was 3.49%; in the GDR and FRG, it was 3.17%; in France, it was 2.83%; in China, it was 2.76%; in Spain, it was 2.36%; in Switzerland, it was 2.94%; in Italy, it was 4.37%; and in Poland, it was 4.15%.

Throughout the world, the number of surgical births rose three to four times in the second half of the 1980s: from 3% in the USSR to 12.7% to 20.4% in the USA, from 12.7% to 16.7% in Europe, and from 18.7% to 18.7% in Canada. In Western countries, caesarean sections accounted for 7.2% of births at the time of the Union’s dissolution, or roughly twice as frequently.

This percentage has increased dramatically over the last three decades, and currently 20% of women globally give birth with the assistance of surgery.

In Russia, caesarean sections account for one in three births on average; this rate is comparable to that of the United States, Great Britain, Italy, Germany, and France.

These procedures outnumber natural birth rates in the Dominican Republic, Cyprus, Egypt, and Turkey. In Brazil, caesarean sections are performed in 70% of cases! However, 10% of births in the Netherlands are surgical—this is the amount that the WHO recommends.

Conversely, only 1% to 2% of deliveries in African nations like South Sudan, Niger, Chad, and Ethiopia involve surgical intervention. This is brought on by societal customs that value the sanctity of childbirth and the lack of access to quality medical care.

In Russia, the regions of Ivanovo (35.6%), Kaliningrad (34.7%), Oryol (34.2%), and Tula (32.1%) have the highest rates of cesarean sections. Yaroslavl Oblast (12.6%), Tuva Republic (14.3%), Crimea (15.7%), and Chukotka Autonomous Okrug (17.1%) had the lowest rates. Every fourth birth occurs in the Novosibirsk region, and every third in Moscow and St. Petersburg.

The World Health Organization is concerned about the rise in cesarean sections, and advises against going over the ten percent threshold. According to the majority of experts, the procedure is frequently carried out in the absence of objective medical indications, and they advocate for stopping unnecessary procedures during childbirth.

In contemporary obstetrics, cesarean sections are now the most frequently performed surgical procedure, providing a safe and frequently essential substitute for vaginal birth. C-sections are becoming more common as a result of improvements in medical technology and increased knowledge of potential birth complications. These procedures enable doctors to guarantee the health of both the mother and the unborn child in urgent situations. Despite the benefits of the procedure, it’s crucial to weigh its increasing popularity against other factors and make well-informed decisions about childbirth options.

Reasons for the increase in operative births

There are now many more reasons for surgical births than there were in the past, when the indications for cesarean sections were related to the mother’s serious illnesses and the child’s life, as natural childbirth is dangerous and can result in death.

To begin with, let’s acknowledge that contemporary obstetrics prioritizes the child, frequently irrespective of the child’s viability. As a result, the mother’s interests, health, and future ability to bear children are considered less important; the risks to the child during a natural birth (with breech presentation or severe prematurity) are deemed higher than the risks of the operation having a negative effect on the mother.

Furthermore, the following factors contribute to the rise in cesarean sections:

• an increase in the age of primiparous women to 30-35 years – at this age, pregnancy can be complicated by certain diseases and pathologies;
• an increase in the number of IVF, often leading to multiple pregnancies;
• lack of information among women and some doctors about the negative consequences of surgical births;
• an increase in the number of repeat pregnancies with a scar on the uterus after a cesarean section and other surgical interventions on the uterus.

Although the last indication is the most prevalent, each case is given unique consideration, so it is not always objective. If there are no more risks, a woman who has had a cesarean section can give birth naturally in the future. Throughout the history of childbirth, there have been ups and downs in the number of operative deliveries due to this cause.

It must be acknowledged that instances in which a cesarean section is clearly indicated are extremely uncommon in contemporary medicine.

Essentially, the procedure is carried out for a variety of reasons, including the midwife and doctor’s professional background, the maternity hospital’s established protocols and standards, the nation in which the child is born, and the laboring woman’s confidence in media and Internet articles regarding cesarean sections. Nowadays, a growing number of operative deliveries are carried out at the request of a woman motivated by her belief that cesarean sections are safer than natural births and her fear of pain.

The commercialization of medicine in general and obstetrics in particular has had an impact on the rise in cesarean sections performed in our nation and overseas during the past 30 years. Maternity hospitals with a high percentage of paid services have a higher incidence of surgical births.

Strangely enough, the use of operative delivery can sometimes make doctors’ jobs easier. After all, in order to perform a natural birth, a doctor must comprehend a woman’s biological mechanism and any deviations from it, carefully evaluate each case, and develop the best possible tactics for delivering a child; in contrast, a cesarean section only requires following a template. Young doctors are performing an increasing number of operations because they think these kinds of births are better for the fetus.

It is important to note that different maternity hospitals and geographical areas have varying rates of operations during childbirth. Cesarean sections are performed far more frequently in large, affluent cities with well-equipped maternity hospitals staffed by highly qualified medical professionals than in tiny, rural hinterland maternity hospitals. In other words, the degree of medical advancement in a given location, clinic, and physician determines how frequently these procedures occur.

Possible consequences of cesarean section

The 21st century has seen a rise in the use of cesarean sections as the most common obstetric procedure due to a lack of a unified system of indications, performing the procedure at the mother’s request, and commercial interests of medical centers. Even with all of modern medicine’s advancements, there are still a lot of postoperative complications.

For the mother, these may be:

• adhesive processes in the abdominal cavity;
• inflammation and divergence of sutures;
• complications from anesthesia;
• restrictions on subsequent natural childbirth;
• risk of placenta growing into the scar area in subsequent pregnancies;
• risk of loss of the uterus;
• risk of postoperative bleeding.

Apart from the aforementioned, there’s a chance that a surgical delivery will have an impact on the mother’s mental health; in a natural delivery, the unconscious maternal instinct is triggered right away, but after a caesarean section, this might take some time.

Possible consequences for the child:

• impaired adaptation of the newborn and decreased adaptation to changing environmental conditions in later life;
• impaired thermoregulation;
• development of respiratory distress syndrome;
• impaired formation of normal microflora in the newborn.

Furthermore, from a biological as well as an anthropological perspective, birth stress is advantageous to humans, claims German perinatal psychologist Ludwig Janus.

To put it briefly, a cesarean section should ideally only be carried out when there are strong signs.

In contemporary obstetrics, cesarean sections are now frequently performed as a safe substitute for natural childbirth when it poses risks. More moms and medical professionals are now reliant on the procedure for both planned and emergency situations as it has developed.

Although discussions regarding overuse of C-sections have been sparked by the rise in their frequency, many mothers and babies still benefit from the procedure, which saves lives and lessens complications. In situations where a natural delivery may not be the best or safest option, it is still a viable option.

The Caesarean section will probably continue to be an essential procedure in the twenty-first century for guaranteeing the health and safety of expectant mothers as well as their babies due to ongoing improvements in medical care.

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