The World Health Organization (WHO) warns that there is a disproportionate number of C‑sections in Latin America. According to the organization’s recommendations, C‑sections should not account for more than 15% of the total births in each country and should be performed only when medically necessary. In most countries in Latin America, the rate exceeds 20%, peaking at over 49% in Ecuador and Chile and 55.5% in Brazil.

The C‑section rate has consistently risen worldwide in the past few decade.

Although C‑sections have been proven to reduce maternal and infant mortality when medically indicated, they are not devoid of risks for the mother and baby. That is why careful medical evaluation is necessary to justify the procedure, taking into consideration the consequences.

Various epidemiological studies have assessed the impact of C‑sections on maternal and infant health. Their conclusions show that a higher C‑section rate is not reflective of healthier mothers and babies.

In fact, the rise in C‑section rates beyond expected values is believed to have significantly contributed to the rapid increase in the prevalence of noncommunicable diseases (NCDs) worldwide. Although the link between these diseases remains controversial, epidemiological studies have observed that C‑section delivery is associated with a higher risk of developing NCDs like asthma, food allergies, type 1 diabetes, and obesity.

Scientists have hypothesized that babies born by C‑section have altered neonatal physiology due to different hormonal, physical, bacterial, and medical exposures compared to those born by vaginal birth.

If actions are not taken to curb this rise, it is estimated that, of the estimated 38 million births that will take place in 2030, one‑third will be by C‑section. At the same time, there is an enormous disparity in C‑section rates: they are too low in poorer countries that need this procedure, and too high in richer countries that do not.

WHO indicates that all physicians, regardless of their area of expertise, should be aware of the benefits of vaginal birth and when C‑sections should be recommended. While an obstetrician‑gynecologist is the obvious choice to treat pregnancy and childbirth, primary care physicians, other specialists, and even health care professionals in emergency rooms can “enter” pregnant women into the health care system for the first time at different points in their pregnancies.

People appear to have forgotten that C‑section, a surgical procedure that facilitates childbirth by means of an incision made in the mother’s abdomen, is only recommended in situations in which vaginal birth may pose risks to the mother, baby, or both. These situations include:

If the mother has had a C‑section in the past or other surgeries on the uterus (although, when appropriate, the doctor and mother may decide on a vaginal birth).

If there are problems with the placenta, such as placenta previa, which can cause dangerous bleeding during vaginal birth. The placenta grows in the uterus and supplies the baby with food and oxygen through the umbilical cord.

If the mother has an infection, like HIV or genital herpes. These infections may be transmitted to the baby during vaginal birth, so a C‑section is safer for the baby.

If the mother has a medical condition that may make vaginal birth risky, such as diabetes or high blood pressure.

If it is a multiple pregnancy (twins or more).

If the baby is very large.

If the baby is not in a head‑down position on the delivery date.

If the umbilical cord has prolapsed. This is when the umbilical cord slips into the vagina before the baby.

If the baby is in danger: they are not receiving enough oxygen or their heartbeat is irregular.

Almost 10 years ago, WHO issued a statement on the increase of C‑section rates. It emphasized that, in the absence of medical complications, pregnancy and labor should follow their natural course and should not be scheduled to fit into a timetable. The benefits of a vaginal birth include:

Benefits of vaginal birth for the mother:

Benefits of vaginal birth for the baby:

The main factor behind the increase in C‑section rates is thought to be economic, as a surgical procedure is more profitable than a vaginal delivery. However, a key study published a decade ago in the United States looked at the epidemiological reasons that could explain higher historical C‑section rates, such as:

Older mothers

Higher rates of obesity in women

More multiple pregnancies

Larger babies

Longer deliveries

Researchers emphasized the need to support women so that they, together with their doctors, can make informed decisions about their pregnancies and deliveries.