Wagner Says WHO Research on Cesarean Rates is Current

Dr. Marsden Wagner, former Director of Women’s and Children’s Health for the World Health Organization, stated via e-mail that the WHO’s 1985 recommendation that cesarean rates by country should not fall below 10% or above 15% remains “absolutely valid and not out-of-date.”

Additionally, Wagner reported that the WHO published a new study in 2007 supporting its original findings that as a country’s cesarean section rate rises above 15%, the maternal mortality too rises. According to Wagner, “[The] unnecessary c-section kills women.”

WHO researchers analyzed nationally representative data available from surveys or vital registration systems on the proportion of births by cesarean section. Their analysis suggests a strong inverse association between caesarean section rates and maternal, infant and neonatal mortality in countries with high mortality levels. There is also some suggestion of a direct association at lower levels of mortality.

Said Wagner, “In the past twenty years in the U.S., the maternal mortality rate keeps rising and rising while the rate of c-section continues to rise. It can now be reliably calculated that [the] c-section is the number one cause of maternal mortality in the U.S.--at least 45% of all maternal death is associated with a c-section.”

According to the CDC's National Center for Health Statistics, the U.S. maternal mortality rate rose to 13 deaths per 100,000 live births in 2004 for a total of 540. This amounts to 45 more maternal deaths than were reported in 2003 and for the first time since 1977, the maternal death rate rose above 10 per 100,000 live births.


View the study "Rates of caesarean section: analysis of global, regional and national estimates"