The ethics behind caesarean section

The World Health Organization recommends that the ideal rate for caesarean sections should be between 10 and 15%. However, caesarean sections have become increasingly common in both developed and developing countries (WHO, 2015).

A recent survey by Macfarlane et al (2015) found caesarean section rates ranging from 14.8% (Iceland) to 24.6% (England) to 52.2% (Cyprus), with a median rate of 25.2%. By contrast, instrumental vaginal delivery rates ranged from 0.5% (Romania) to 12.6% (England) to 16.4% (Ireland), with a median rate of 7.5%. These variations, the authors conclude, illustrate a lack of consensus about practice and raise questions for further investigation.

Macfarlane et al's (2015) data support the contention of Penna and Arulkumaran (2003: 399) that obstetricians are ‘… more likely to agree to a request for a non-medically indicated caesarean section than in the past’, citing a 1986 study showing that most obstetricians refused to perform unnecessary caesareans; but in 1998 another study found that 69% complied with such requests.