Reasons for the Increase and Ways to Reduce the Frequency of Cesarean Sections in Modern Obstetrics

The progressive increase in the number of cesarean sections, which is not accompanied by a decrease in the perinatal mortality rate, is an urgent problem not only in obstetrics, but in the health care system in general. The frequency of operative delivery is influenced by both medical and non-medical factors. Moreover, the frequency varies across regions of the world and countries with different levels of economic development. At the present stage, the increase in the number of surgical deliveries in developed countries is due to changes in population health indicators (age, morbidity). The attention of WHO and associations of obstetricians and gynecologists is drawn to the development of measures to stabilize and reduce the frequency of cesarean sections. However, the proposed measures to reduce it through administration in obstetric hospitals and non-medical measures do not have an effect. There is evidence of an increase in the incidence of complications for the mother and fetus when indications for cesarean section are limited. A safe reduction in the frequency of caesarean sections is possible only with an integrated approach, including new solutions that improve the quality of medical care in general (social measures to support families, optimization of medical processes, introduction of decision support systems, improvement of medical technologies for pregnancy and childbirth).