It has recently been reported that nearly seven out of ten babies are now born via C-section. Over the last decade there has been a huge increase in C-sections within South Korea.
In 2016 just 42.5% of births were via C-section. This increased to over half in 2019. In the latest data it has increased to 70.2%.
According to the National Health Insurance Service (NHIS) data obtained by Rep. Kim Yoon of the Democratic Party, a member of the National Assembly’s Health and Welfare Committee, released on Wednesday, out of the 242,103 births last year covered by the analysis, 169,891, or 70.2 percent, were cesarean deliveries.
In 2016 just 42.5% of births were via C-section. This increased to over half in 2019. In the latest data it has increased to 70.2%.
There has also been an increase in C-sections amongst younger mothers and first time mums.
The percentage of births via C-section for those 34 and under has increased from 39.2% in 2016 to 67.7%. The percentage for first time mothers has increased from 45.6% to 74.8%.
This shows that there has been an overall change in births. However, this alone does not show what causes individual mothers to have C-sections.
A key factor in South Korea is that women are having children at an older age. When pregnant at an older age there is a higher chance of complications. However, this does not mean that women will have a C-section.
Some women will have a preference for a planned C-section. This can be down to wanting to know when they will give birth or being worried about the pain of labor and complications with giving birth vaginally.
However, there can be issues with the availability of obstetric care. Doctors in South Korea have expressed concerns about the lack of obstetricians. There are concerns about providing maternity care in regional areas. There could also be concerns about medical negligence claims which may have an effect on how doctors decide to proceed with deliveries.
Therefore, women may choose to have a planned C-section rather than giving birth vaginally.
There was a large difference in C-sections throughout South Korea.
The region with the highest percentage of C-sections was Gangwon at 76.8%. This was followed by North Chungcheong and Busan both at 76.7% and 75.9% respectively. The region with the lowest percentage was Gwangju at 55.2%. Jeju had the second lowest percentage at 61.6%.
This raises questions about differences in the health of mothers, availability of obstetric care and availability of facilities to deal with complicated pregnancies.
Regional areas have concerns about the lack of doctors. To provide maternity care there needs to be trained obstetricians, anesthetic and the ability to deal with emergencies.
However, there is no evidence to suggest that there is an increase in C-sections due to lack of staff. Further research would be needed to see how much of an impact staffing, clinical risks, personal choices and hospital practices have on the increase.
The WHO have stated that beyond around 10% C-section rates there is no further decrease in maternal and neonatal mortality. However, this should not be used as a target for individuals or nationally. C-sections are vital when medically indicated and they can save lives.
The concern is that women are not receiving the right options for their delivery. They should be having C-sections due to clinical need.
To try to overcome this issue it may be useful to look into why there is an increase in C-sections. By improving obstetric services in under served areas it can help improve access to maternity care. Addressing concerns about medical negligence can help ensure that doctors can make decisions based on clinical need for their patients.
The increasing trend in women opting for C-section deliveries in South Korea points to issues with providing maternal care to women. It is very important to understand why there has been an increase to see if any changes need to be made to clinical practice.
(Rh/MF)
