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Interactive Paediatrics

Increased LSCS rates and its causes

There is a recent rise in the LSCS deliveries. This has been addressed in a recent medscape article. The excerpt from the article is as below. You can read the full article at-(link)

 

"The frequency of surgical birth has increased from 4% in 1965 to about 33% today, despite World Health Organization (WHO) recommendations that a 5% to 10% rate is optimal and that a rate greater than 15% does more harm than good.

Reasons for this increase have been discussed profusely:

  • The surgical focus of obstetrics and the need to train residents;
  • The low priority and few practical skills for supporting women's abilities to labor and give birth naturally;
  • A rigid view of the duration of normal labor; and
  • A low threshold of definition for 'labor dystocia' (the justification for up to 60% of cesarean births).

Surgical birth is also a 'side effect' of interventions associated with actively managed labor: induction, artificial rupture of membranes, labor medications, and fetal monitoring. Policies against vaginal birth after cesarean (VBAC) and, increasingly, unsupported 'supply-side' justifications such as "baby seems large," also drive the trend toward cesareans. A recent report by the Lamaze Institute associates surgical birth with obstetricians' personalities -- specifically their anxiety levels."