WHO Statement on Caesarean Section Rates

WHO Statement on Caesarean Section Rates

22 July 2015 | AP Betran, MR Torloni, JJ Zhang, AM Gülmezoglu
The World Health Organization (WHO) has issued a statement on caesarean section (CS) rates, emphasizing the need for a more nuanced approach to determining optimal rates. In 1985, a WHO meeting concluded that CS rates should not exceed 10-15% to ensure safe and effective childbirth. However, this recommendation has been widely misinterpreted and applied to healthcare facilities without considering their specific contexts. Over the past 30 years, CS rates have risen globally, raising concerns about the need to reassess the recommended rate in light of improved clinical care and evidence-based practices. The WHO statement highlights that CS rates above 10% do not reduce maternal and newborn mortality, but the association with other outcomes like stillbirths and perinatal morbidity remains unclear due to insufficient data. The statement stresses the importance of quality of care, noting that CS is associated with short- and long-term risks, especially in settings lacking proper facilities or resources. CS should be performed only when medically necessary, not as a target rate. The WHO proposes the Robson classification as a global standard for monitoring CS rates in healthcare facilities. This classification, based on obstetric characteristics, allows for more accurate and comparable assessments of CS rates. The statement encourages the use of this classification to improve care and inform practice. It also calls for uniform data collection to better understand CS rates and outcomes within different groups defined by the Robson classification. The WHO aims to support countries in implementing this classification to enhance transparency and improve maternal and perinatal outcomes.The World Health Organization (WHO) has issued a statement on caesarean section (CS) rates, emphasizing the need for a more nuanced approach to determining optimal rates. In 1985, a WHO meeting concluded that CS rates should not exceed 10-15% to ensure safe and effective childbirth. However, this recommendation has been widely misinterpreted and applied to healthcare facilities without considering their specific contexts. Over the past 30 years, CS rates have risen globally, raising concerns about the need to reassess the recommended rate in light of improved clinical care and evidence-based practices. The WHO statement highlights that CS rates above 10% do not reduce maternal and newborn mortality, but the association with other outcomes like stillbirths and perinatal morbidity remains unclear due to insufficient data. The statement stresses the importance of quality of care, noting that CS is associated with short- and long-term risks, especially in settings lacking proper facilities or resources. CS should be performed only when medically necessary, not as a target rate. The WHO proposes the Robson classification as a global standard for monitoring CS rates in healthcare facilities. This classification, based on obstetric characteristics, allows for more accurate and comparable assessments of CS rates. The statement encourages the use of this classification to improve care and inform practice. It also calls for uniform data collection to better understand CS rates and outcomes within different groups defined by the Robson classification. The WHO aims to support countries in implementing this classification to enhance transparency and improve maternal and perinatal outcomes.
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