Our Summary

This research is about the rise in Caesarean section (C-section) rates worldwide, which could suggest that the procedure is being overused on healthy women and babies. This overuse can result in harm to mothers and babies and negatively impact the sustainability of maternity care. The researchers aim to understand why attempts to reduce unnecessary C-sections have not been successful.

To do this, they undertook a systematic review of previous research using a method called meta-ethnography. This involved searching multiple databases for relevant studies, assessing their quality, and then synthesizing the data from these studies to identify common themes.

They found 25 studies from 17 countries, involving over 1,500 stakeholders. From these studies, they identified three primary themes: factors related to health systems, organizations, and structures; human and cultural factors; and factors related to how change can be achieved. They noted that power differences within and between systems, as well as commitment from stakeholders, significantly influence C-section rates, regardless of the effectiveness of specific interventions to reduce them.

In conclusion, the researchers found that non-medical approaches to reducing C-sections are heavily influenced by power structures and stakeholder commitment. The biggest barriers occur when plans to reduce C-section rates go against existing system and cultural norms.

FAQs

  1. What is the aim of this research about Caesarean section rates?
  2. What themes did the researchers identify in their systematic review of previous research?
  3. What are the biggest barriers to reducing C-section rates, according to this research?

Doctor’s Tip

One helpful tip a doctor might give a patient about cesarean section is to discuss with their healthcare provider the reasons why a C-section may be necessary in their specific situation. It’s important for patients to understand the risks and benefits of the procedure, as well as any alternatives that may be available. Open communication with their healthcare team can help ensure that the decision to have a C-section is well-informed and in the best interest of both the mother and baby.

Suitable For

Overall, the researchers suggest that a more holistic approach is needed to address the overuse of C-sections, taking into account the complex interactions between health systems, cultural beliefs, and individual preferences. They recommend involving all stakeholders in decision-making processes and addressing power dynamics within healthcare systems to effectively reduce unnecessary C-section rates.

Timeline

Before a C-section, a patient may experience a prolonged labor, failure to progress in labor, fetal distress, or other complications that necessitate the procedure. They will likely undergo discussions with healthcare providers about the need for a C-section, potential risks and benefits, and consent for the surgery.

During the C-section, the patient will be prepped in the operating room, receive anesthesia, and have the surgery performed. They may experience anxiety, discomfort, and fear during the procedure.

After the C-section, the patient will be monitored closely for any complications, such as infection, blood loss, or blood clots. They will receive pain medication, support in breastfeeding, and guidance on post-operative care.

In the following weeks and months, the patient may experience physical discomfort, emotional challenges, and difficulties in caring for their newborn while recovering from the surgery. They will have follow-up appointments with their healthcare provider to monitor their healing and address any concerns.

What to Ask Your Doctor

Some questions a patient should ask their doctor about cesarean section include:

  1. What are the reasons for recommending a C-section in my case?
  2. Are there any alternative options to a C-section that could be considered?
  3. What are the potential risks and complications associated with a C-section?
  4. How will a C-section impact my recovery compared to a vaginal birth?
  5. Will I be able to have skin-to-skin contact with my baby immediately after a C-section?
  6. What can I expect during and after the C-section procedure?
  7. How will a C-section affect my future pregnancies and childbirth options?
  8. Are there any specific steps I can take to reduce my likelihood of needing a C-section?
  9. What is the hospital’s C-section rate and their policies regarding the procedure?
  10. Can you provide me with resources or information on C-sections to help me make an informed decision?

Reference

Authors: Kingdon C, Downe S, Betran AP. Journal: PLoS One. 2018 Sep 4;13(9):e0203274. doi: 10.1371/journal.pone.0203274. eCollection 2018. PMID: 30180198