JAMA publishes Peking University Research: China's cesarean section rate keeps rising in 10 years

Pregnancy and childbirth are natural processes, which are safe in most cases In medicine, cesarean section is necessary due to complications, accounting for about 10% - 15% On the contrary, inappropriate cesarean section may also pose a threat to the health of mothers and infants For many years, the proportion of cesarean section in China has been much higher than the above-mentioned figures which meet the medical needs A study conducted by Professor Liu jianmeng, School of public health, Peking University, analyzed the trend of cesarean section in China from 2008 to 2018, which was recently published in the Journal of the American Medical Association Screenshot source: JAMA Based on the data of China's maternal and infant health statistics, the study analyzes the data of live births and divides the degree of urbanization in different regions: super cities (population ≥ 5 million), general cities (population < 5 million) and rural areas From 2008 to 2018, more than 160 million babies were born, and the proportion of cesarean section increased from 28.8% in 2008 to 34.9% in 2014 and 36.7% in 2018 In the past ten years, the proportion of cesarean section showed an overall growth trend, with an annual rate of change (APC) of 1.8% Source: pexels On the overall trend: From 2007 to 2012, APC increased rapidly, reaching 4.6% It then remained stable for about five years This may be related to the promotion of the mother baby friendly demonstration hospital plan at that time, including the promotion of natural childbirth It grew again after 2016, with APC at 3.5% This may be attributed to the improvement of medical services in rural areas, the end of the mother infant friendly demonstration hospital program, and the increase of cesarean section history and the number of elderly mothers after the opening of the two child policy ▲ overall change of cesarean section proportion in China from 2008 to 2018 (picture source: reference [1]) In terms of urban-rural differences, 7.8% of the infants were born in super cities, 20.5% in ordinary cities and 71.7% in rural areas On the whole, the gap between urban and rural areas in the proportion of cesarean section is narrowing, and the absolute gap has been reduced from 25.1% in 2008 to 9.6% in 2018 In the past ten years, the proportion of cesarean section in rural areas has been lower than that in urban areas, but it has been growing all the time The proportion of cesarean section in ordinary cities has not changed much as a whole, while that in super cities has declined ▲ the proportion of cesarean section in Chinese super cities (Orange), ordinary cities (blue) and rural areas (dark blue) in 2008-2018 (photo source: reference [1]) The research team pointed out that in the past decade, China has made many efforts to reduce the rate of cesarean section Although the proportion of cesarean section has declined in some cities, it is still rising at the national level, especially in rural areas, which cover most of the population In October last year, the lancet once pointed out that from the medical point of view, excessive or insufficient cesarean section is harmful, but in recent years, the proportion of cesarean section has increased rapidly worldwide, and nearly half of cesarean section may not be necessary at present.