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THE NUMBER OF babies born through caesarean section (C-section) almost doubled between 2000 and 2015 – from 12% to 21% of all births – according to a series of three papers published in The Lancet.
The studies found that while the life-saving surgery is still unavailable for many women and children in low-income countries and regions, the procedure is overused in many middle and high-income regions.
C-section is a life-saving intervention for women and newborns when complications occur, such as bleeding, foetal distress, hypertensive disease, and babies in abnormal position. But, the surgery is not without risk for mother and child, and is associated with complications in future births.
It is estimated that 10-15% of births medically require this procedure due to complications, suggesting that average C-section use should lie between these levels.
Series lead author Dr Marleen Temmerman, Aga Khan University in Kenya said: “Pregnancy and labour are normal processes, which occur safely in most cases. The large increases in C-section use – mostly in richer settings for non-medical purposes – are concerning because of the associated risks for women and children.
“C-sections can create complications and side effects for mothers and babies, and we call on healthcare professionals, hospitals, funders, women and families to only intervene in this way when it is medically required,” says “In cases where complications do occur, C-sections save lives, and we must increase accessibility in poorer regions, making C-sections universally available, but we should not overuse them.”
Disparities in global C-section use
The studies found that C-sections continue to be overused in North America, Western Europe, Latin America and the Caribbean, where rates increased by around 2% per year between 2000-2015.
The authors of the series of reports found that the increases in the procedure are attributed both to more births taking place in health institutions and to greater frequency of intervention through C-section in health facilities.
There were significant differences within low and middle-income countries, where the wealthiest women were six times more likely to have a C-section compared with the poorest women, and where C-section was 1.6 times more common in private facilities than public facilities. The authors suggest that this could be explained by persistent issues with shortages in health facilities and staff in vulnerable and rural populations.
Harms associated with C-section overuse and underuse
C-section improves maternal, newborn and child survival when complications arise, and can also lower the risk of incontinence and prolapse.
However, there are short and long-term risks associated with C-sections for mothers and children, and there are no benefits of C-section in cases without a medical indication. In these instances, women and children can be harmed or die from the procedure, especially when there are not sufficient facilities, skills, and health care available.
Maternal death and disability is higher after C-section than vaginal birth. In particular, C-sections have a more complicated recovery for the mother, and lead to scarring of the womb, which is associated with bleeding, abnormal development of the placenta, ectopic pregnancy, stillbirth and preterm birth in subsequent pregnancies.
Professor Jane Sandall of King’s College London said: “Given the increasing use of C-section, particularly cases that are not medically required, there is a crucial need to understand the health effects on women and children. Greater understanding of this is important to help inform decision making by families, physicians, and policy makers.
“C-section is a type of major surgery, which carries risks that require careful consideration. The growing use of C-sections for non-medical purposes could be introducing avoidable complications, and we advocate that C-section should only be used when it is medically required.”
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its a sign of the times on O’Connell St, a wasted needle can be found on every street corner these days
@veronikahladova: yawn
@veronikahladova: again… yawn
@veronikahladova: You’ve got a point.
Stop the spin. Nobody ever liked it.
@Sue: I like it Sue, you can’t really speak for everyone!
@Sue: you are of course speaking for yourself here Sue and not everyone. Never assume that everyone thinks the same as you.
I like it and its part of Dublin
@Áinín: apparently she does for 24 people
@Sue: I’ve liked it from day 1
@Sue: I’d stretch to saying I love it
@Sue: I actually like it.
@Sue: Loved it from Day 1
@Sue: Agreed. It’s lazy. Slapdash. Bring back the fluzey – at least it served a practical purpose, i.e.:bin. The spire…it kind of looks like even ‘it’ wants out while it waits to blast off.
@Sue: I like it. But I suppose I’m unusual in Ireland in that I’m an Irishman who’s not full of self hate towards everything that happens in this country even if it’s a good thing!
“I can see Clearys now the crane has gone”
No creativity .. it evokes absolutely nothing when you look at it .. the laziest design ever , imagine all the potential .. at the end of the day dublin hasn’t hit much atmosphere or personality anymore … so if the deign was planning for the future – the needle is a great depiction of all the needle used for heroine in the area
@Dublin sunrise: Heroine , a La The Commitments , brilliant comment .
It would be nice if they actually maintained it at least. The light strip on the top of the spire has been broken years now.
20 years?! Seems like yesterday when I watched it being raised, piece by piece, from my office window nearby. I liked it then, I love it now. It always seemed a shame that whoever designed it didn’t put a viewing platform in it so the public could get an elevated view over the city. Apparently the Nelson Pillar before it had that function. Still, I love it’s simplicity and it’s on my favourite street in the country. It’s special.
@Noel_Random: Would be interested to know why it’s your favourite street? From my perspective, it has serious potential with its layout and width, and there is also the GPO which is an imposing historic building. What I don’t like about it is that there is almost always an air of menace about the place and it’s not helped by the lack of visible policing day or night. Shopping, drinking and earning out is also severely lacking and it seems to be majority take away food or convenience shops. I’d love to see it change though.
@Longlin: pretty much exactly you describe. The scale, some exceptional buildings. I don’t sense an air of menace at all, mind you, I’m not in the city at night much anymore. What I often suggest to people who are too nervous to enjoy it is to sit outside a pub like Murray’s or cafe nearby on the upper end of the street and just watch the passers by. Apart from tourists, there’s a whole world of new Irish who have brought it back to life. It’s almost like a mini trip to another city like Paris! Too many fast food outlets and too many empty sites sitting there for years but such potential as you say.
@Noel_Random: I was today days old when I realised it was installed in pieces
@Noel_Random: *its* simplicity
The stiletto in the getto we’d be lost without it ,it’s one of our own
@James Delaney: the erection at the intersection
@Henri Poincaré: the spire in the mire
@James Delaney: the stiffy at the liffey
@James Delaney: the poker near Croker
@James Delaney: the pin in the bin
It is an emblem of Dublin and a great alternative to a picture of a pint.
It was a amity project then and it’s still ugly as sin now.
@Pete Gilmartin: Vanity*
@Pete Gilmartin:
Jaws…
I like that our main street has an iconic symbol. Art is always aspirational. I would love to know what it symbolizes to people. That would be an interesting comment thread rather than a yes or no..do you like it or not question. For me it symbolises looking up.. aspiration. Hope. It’s solid. Permanent. Hope constant.. consistent. Secure. There’s a safety about it’s presence.
@derek: u still talking about that hunk of metal or your safety blanket?
A needle – it is very fitting – for all the needles used in the area for people to self medicate … while others not too far away rush along with their brown Thomas ( Chinese owned) paper advertising bags …purch the murch to impress the lurch .. i could easily vomit .
The stiffy by the Liffey
Love it. Really amazing to look up at it when standing at its base or from the end of O Connel st.
Has grown on me over the years.
It’s the nicest thing about o’Connell St.. although that’s not saying much. But hey clearys clock is back. Still trying to remember the name of me date that never turned up 1982 .b I t c h
@Paul Gorry: She sure made a 41 – year impression on you!
@Paul Gorry: lol
I dislike the Spire for what it represents; another monument supposed to be maintained by Dublin City Council but ignored and left to flounder. The lights have not been fully repaired for a number of years now, and seriously need replacing. For the de facto monument of the city to International visitors to not be fully lit, its embarrassing.
They should put a wind power generator on top and panel the sides with solar panels.
@Rafa Condron: I was thinking about how technologies like this have moved in the last 20 years and the potential for a night time LED display also exists.. wonder what would be designed differently
I preferred the Anna Livia (affectionately known as the floozie)!!
I cannot stand it as a Dubliner,it’s meaningless,I mean we had a World acclaimed piece,before this,Eamon O’ Doherty’s Anna Livia,but due to a combination of wild egomania(the spire)and neglect(DCC)we end up with this.I am a City Centre Trader for 30 years (quite close to it)and I have yet to hear one positive comment.Some visitors have asked;how does one get to the top,and appear incredulous when told ‘you can’t.Please re.ove it. James Carroll.
No poll, for this pole.
It’s the perfect symbol of the north inner city’s drug problem.
I like it love looking at it from Henry street.
Strange that I’ve never seen a postcard of it ,,,I’m sure there are some .
I like it. I loved the light exhibition on it years ago, when spot lights traced patterns on it.
Nobody liked the Eiffel Tower either at first.
I always look for it and then I “know I am in Dublin”…sounds a bit silly but I like it and it is a visual landmark that is part of my Dublin experience.
I also used to teach Junior Cert Maths grinds and it is a trigonometry exam question from one of the years which I always found interesting.
I like it- it’s different and I love to stand at the bottom and look up. You can’t please everyone
I like it, I’m a fan.
The spire is modern day clearys clock
I think most people’s opinion is that its alright but could have been so much better
No.
I like it. could be maintained better.. at least it’s not a statue to the virgin mary or a politician. It’s uninspiring like most of the comments here.
Always liked it.
I hear the spire is so big you can see it from anywhere in the world.
@Irish Antichrist: there are treatments available for those types of disorders.
Pretentious, disappointing, and a tad corporate. So much for artistic Ireland – oh wait…it has squiggles on it. (Pretentious and disappointing are now toxic words, it seems).
What would have been truly brave and artistic: Build four, one for each quarter of the city, and have them all bending and meeting in the middle. But nooo…. Let’s build the simplest design since the wheel and all be looking up like gombeens.
I hate it. Does that give it artistic credibility?
There’s nothing to look at in Dublin really. Ugliest European capital city there is. No wonder some may like the spire lol
Good meeting point for all the Talbot Street “natives”.
Certainly unique..something that makes a constant revenue maybe would of been better but I’m not from Dublin so
This is what the Spire signifies to me, “Provehito in Altum” or Launch into the Deep like a rocket!
the spire is a landmark used to measure distance for anyone trying to rent a place in the city centre. most ads read “x minutes from the spire”.
I think it’s a total eyesore, looks like an over sized lamp post and a total waste of money
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