A detailed investigation and understanding of the effective factors in the rapid increase in the cesarean rate in Iran

Caesarean section, also known as C-section or caesarean delivery, is the surgical procedure by which one or more babies are delivered through an incision in the mother's abdomen, often performed because vaginal delivery would put the baby or mother at risk. Reasons for the operation include obstructed labor, twin pregnancy, high blood pressure in the mother, breech birth, shoulder presentation, and problems with the placenta or umbilical cord. A caesarean delivery may be performed based upon the shape of the mother's pelvis or history of a previous C-section. A trial of vaginal birth after C-section may be possible. The World Health Organization recommends that caesarean section be performed only when medically necessary. A C-section typically takes ۴۵ minutes to an hour. It may be done with a spinal block, where the woman is awake, or under general anesthesia. A urinary catheter is used to drain the bladder, and the skin of the abdomen is then cleaned with an antiseptic. An incision of about ۱۵ cm (۶ inches) is then typically made through the mother's lower abdomen. The uterus is then opened with a second incision and the baby delivered. The incisions are then stitched closed. A woman can typically begin breastfeeding as soon as she is out of the operating room and awake. Often, several days are required in the hospital to recover sufficiently to return home. According to the recommendations of the World Health Organization, in no part of the world should the ratio of cesarean section be more than ۱۰-۱۵% of births. But unfortunately, the statistics published in most parts of the world are very different from this ratio. Cesarean delivery increases the health risk of mothers, slows down the recovery process of mothers, and increases the relative risk of death in mothers. Some sources believe that most caesarean sections are unnecessary. Worldwide, the caesarean section rate has increased from ۶.۷% in ۱۹۹۰ to ۱۹.۱% in ۲۰۱۴, which represents a growth of ۱۲.۴%. The cesarean rate in developing countries has grown by ۱۴.۶% and in developed countries by ۱۲.۷%. Also, the cesarean rate in the United States has increased from ۲۰.۷% in ۱۹۹۶ to ۳۲.۸% in ۲۰۱۱. In Iran, the caesarean section rate has increased from ۱۶% in ۱۳۶۴ to ۶۰% in ۱۳۹۲. The current cesarean rate, except for less developed countries, is continuously increasing and is higher than the medically justifiable amount. The steep and inappropriate increase in the rate of cesarean section indicates a health problem in Iran and requires the attention of the authorities. Since there are several underlying factors in the need for cesarean delivery, various strategies including mother-friendly hospitals, development of standard protocols, preparation classes for mothers, midwives and gynecologists, training workshops for specialists and midwives should be implemented to prevent unnecessary use. Use this method.