A caesarean section (CS) is a surgical procedure that can effectively prevent maternal and newborn mortality and morbidity when used for medically indicated reasons. Globally, CS rates have been increasing over the past decades. Recent estimates have suggested that across 150 countries, 18.6% of all births occur by CS, ranging from 1.4% to 56.4% across different countries. The global CS rate increased by 12.4% (from 6.7% to 19.1%) from 1990 to 2014 ; however, this trend has not been accompanied by significant maternal or perinatal health benefits which suggest that a growing proportion of CS are not necessary. CS is associated with short and long-term risks for women, children, and future pregnancies, as well as substantial healthcare costs. These risks are higher in settings where women have limited access to comprehensive obstetric care. Sustained increases in CS rates are a major public health concern and there is an urgent need for evidence-based guidance to address this trend.
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