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Re "Caesarean Births in U.S. Hit 32% in '07, Heightening Concern Among Doctors" (news article, March 24): As a practicing obstetrician-gynecologist for more than 20 years, I share the concern about the increasing use of Caesarean section.
However, there is continuing debate, the study said, about the use of Caesarean section for babies who are breech (feet first), for multiple births and women who have had a C-section already.
The use of Caesarean section on the other hand delayed initiation.
Particularly in low-resource settings, avoiding liberal use of Caesarean section, even for breech presentation at term, is advised.
The lack of uniformity in the use of caesarean section in England was not associated with clinical indications for caesarean section.
At the child level we included sex of the child, birth weight, delivery in hospital and in particular use of Caesarean section as explanatory variables.
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Another factor in the United States, she said, is the increasing use of Caesarean sections and labor-inducing drugs to deliver babies early.
An exception was in Ukraine where efforts to encourage evidence-based policies and reduce the use of Caesarean sections was found to be cost saving.
We assessed which mechanism explains the higher rate of caesarean sections in the former West than East Germany: a more liberal use of caesarean sections in the case of relative indications or more common caesarean sections without indications.
Support should be part of a global effort towardappropriate use of caesarean sections – limiting the intervention's frequency where it is overused and increasing it where use istoo low.
In recent years the emergence of medical insurance, the favorable transformation of public attitudes towards hospital birth and the widespread use of Caesarean sections have led Chinese women to prefer obstetricians [ 21- 23].
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com