20. Preventing Unnecessary Cesarean Sections in Latin America

We’re dealing with another delivery dilemma, the rising global rates of medically unnecessary Cesarean sections. Latin America has some of the highest C-section rates in the world and Pedro Delgado tells us about the complex interplay of factors related to childbearing women, societal norms, clinicians, and healthcare systems that drives this practice. It’s about striking a delicate balance — ensuring medically necessary C-sections are accessible while reducing overuse, all while respecting women's rights to choose and promoting informed decision-making.References:Perner MS, Ortigoza A, Trotta A, et al. Cesarean sections and social inequalities in 305 cities of Latin America. SSM - Population Health. 2022;19:101239. doi:10.1016/j.ssmph.2022.101239Betrán AP, Temmerman M, Kingdon C, et al. Interventions to reduce unnecessary caesarean sections in healthy women and babies. Lancet. 2018;392(10155):1358-1368. doi:10.1016/S0140-6736(18)31927-5Editorial. Stemming the global caesarean section epidemic. Lancet. 2018;392(10155). (Specific page numbers for the editorial were not provided in the source, but it is part of the same Lancet series issue as the Betrán et al. article).World Health Organization. WHO Recommendations Non-clinical Interventions to Reduce Unnecessary Caesarean Sections. World Health Organization; 2018. WHO/RHR/18.24.Borem P, Sanchez RC, Torres J, et al. A quality improvement initiative to increase the frequency of vaginal delivery in Brazilian hospitals. Obstet Gynecol. 2020;135(2):415-425. doi:10.1097/AOG.0000000000003619Metwali NY, Ahmed RA, Timraz JH, et al. Evidence-Based Strategies to Minimize Unnecessary Primary Cesarean Sections: A Comprehensive Review. Cureus. 2024;16(11):e74729. doi:10.7759/cureus.74729