The most commonly performed operation in the world is cesarean section, and rates of cesarean childbirth delivery vary widely from country to country, from as few as 2 percent to more than 50 percent of live births. The World Health Organization recommends countries not exceed 10 to 15 percent (10 to 15 C-section deliveries per 100 live births) for optimal maternal and neonatal outcomes.

New research examining the relationship between C-section rates and maternal and neonatal mortality in 194 countries concludes that as the country-level C-section rate increases up to 19 percent, maternal and neonatal mortality rates decline. C-section delivery rates above 19 percent showed no further improvement in maternal and neonatal mortality rates.

Researchers from Ariadne Labs, a joint center of Brigham and Women’s Hospital and the Harvard T.H. Chan School of Public Health, and Stanford University School of Medicine gathered and correlated national C-section, maternal and neonatal mortality rates in a single year (2012) for all 194 World Health Organization member countries. Mathematical modeling was used to impute C-section rates for countries where data was missing and to account for other contributing factors such as health expenditure. This is the first study to offer a comprehensive analysis of C-section rates for all WHO counties in a single year. That approach avoids bias caused by using data from varying years, since C-section rates and mortality change over time.

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