Doctors warn of global C-section ‘epidemic’

Doctors hold one of the newborn triplet of a mother  as she undergoes a caesarean section procedure at the Santa Ana public maternity hospital in Caracas, Venezuela. (REUTERS/Carlos Garcia Rawlins/File Photo)
Updated 13 October 2018
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Doctors warn of global C-section ‘epidemic’

  • In 2015, the most recent year for which complete data is available, doctors performed 29.7 million C-sections worldwide — 21 percent of all births
  • The study warned that in many settings young doctors were becoming “experts” in C-section while losing confidence in their abilities when it comes to natural birth

PARIS: Worldwide Caesarean section use has nearly doubled in two decades and has reached “epidemic” proportions in some countries, doctors warned Friday, highlighting a huge gap in childbirth care between rich and poor mothers.
They said millions of women each year may be putting themselves and their babies at unnecessary risk by undergoing C-sections at rates “that have virtually nothing to do with evidence-based medicine.”
In 2015, the most recent year for which complete data is available, doctors performed 29.7 million C-sections worldwide — 21 percent of all births. This was up from 16 million in 2000, or 12 percent of all births, according to research published in The Lancet.
It is estimated that the operation — a vital surgical procedure when complications occur during birth — is necessary 10-15 percent of the time.
But the research found wildly varying country rates of C-section use, often according to economic status: in at least 15 countries more than 40 percent births are performed using the practice, often on wealthier women in private facilities.
In Brazil, Egypt and Turkey, more than half of all births are done via C-section.
The Dominican Republic has the highest rate of any nation, with 58.1 percent of all babies delivered using the procedure.
But in close to a quarter of nations surveyed, C-section use is significantly lower than average.
Authors pointed out that while the procedure is generally over-used in many middle- and high-income settings, women in low-income situations often lack necessarily access to what can be a life-saving procedure.
“We would not expect such differences between countries, between women by socioeconomic status or between provinces/states within countries based on obstetric need,” Ties Boerma, professor of public health at the University of Manitoba, Winnipeg, and a lead author on the study, told AFP.
Jane Sandall, professor of social science and women’s health at King’s College London and a study author, told AFP that there were a variety of reasons women were increasingly opting for surgery.

Losing confidence in natural birth
These include “a lack of midwives to prevent and detect problems, loss of medical skills to confidently and competently attend a vaginal delivery, as well as medico-legal issues.”
Doctors are often tempted to organize C-sections to ease the flow of patients through a maternity clinic, and medical professionals are generally less vulnerable to legal action if they choose an operation over a natural birth.
Sandall also said there were often “financial incentives for both doctor and hospital” to perform the procedure.
The study warned that in many settings young doctors were becoming “experts” in C-section while losing confidence in their abilities when it comes to natural birth.
It also identified an emerging gap between wealthy and poorer regions within the same country. In China, C-section rates diverged from 4 percent to 62 percent; in India the range was 7-49 percent.
While the US saw more than a quarter of all births performed by C-section, some states used the procedure more than twice as often as others.
“It is clear that poor countries have low C-section use because access to services is a problem,” said Sandall. “In many of those countries, however, richer women who live in urban areas, have access to private facilities have much higher C-section use.”

Easy way out
C-sections may be marketed by clinics as the “easy” way to give birth, but they are not without risks.
Maternal death and disability rates are higher after C-section than vaginal birth. The procedure scars the womb, which can lead to bleeding, ectopic pregnancies (where the embryo is stuck in the ovaries), as well as still- and premature future births.
The authors suggested better education, more midwifery-led care and improved labor planning as ways of ensuring C-sections are only performed when medically necessary, as well as ensuring women properly understand the risks involved with the procedure.
“C-section is a type of major surgery, which carries risks that require careful consideration,” said Sandall.
In a comment accompanying the study, Gerard Visser of the University Medical Center in the Netherlands, called the rise in C-sections “alarming.”
“The medical profession on its own cannot reverse this trend,” he said.
“Joint actions are urgently needed to stop unnecessary C-sections and enable women and families to be confident of receiving the most appropriate care for their circumstances.”
 


Rockfall at Indonesian limestone quarry kills eight

Updated 2 sec ago
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Rockfall at Indonesian limestone quarry kills eight

CIREBON: At least eight people were killed and a dozen injured Friday in a rockfall at a limestone quarry on Indonesia’s Java island, police said.
The company overseeing the mine was operating legally but safety standards were lacking, according to West Java governor Dedi Mulyadi, who said he has ordered its closure following the collapse.
Workers and heavy equipment were buried when rocks suddenly crumbled at the mining site in the city of Cirebon in West Java province at around 09:30 am local time (0230 GMT).
“We are now focusing on evacuating victims. Until now, eight people have been found dead, and 12 others were injured and have been taken to hospitals,” local police chief, Sumarni, who like many Indonesians has one name told AFP.
Rescuers were still scouring the site to find more victims who might still be trapped under the debris, deploying excavators for the search effort.
Friday’s incident was the second time the quarry collapsed. Parts of the mine collapsed in February but there were no casualties reported.
“I decided to shut down the pit permanently, not just this pit but also other pits nearby,” Dedi told Metro TV.
Mining accidents are common across the mineral-rich Southeast Asian archipelago, especially in unlicensed sites where safety protocols are often ignored.
In 2023, eight workers died after being trapped in an illegal gold mine in Central Java.
In July, last year, at least 23 people died and 35 others were missing when a landslide hit a remote village near an illegal gold mine on the central island of Sulawesi.

EU to propose more flexible climate goal in July, sources say

Updated 29 min 12 sec ago
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EU to propose more flexible climate goal in July, sources say

  • The proposal will set an EU goal to cut net greenhouse gas emissions 90 percent by 2040, compared with 1990 levels, the diplomats saiD

BRUSSELS: The European Commission will propose a new EU climate target in July that includes flexibilities for how countries meet it, as Brussels attempts to fend off mounting criticism of Europe’s environmental aims, EU diplomats told Reuters.
The European Union’s climate commissioner, Wopke Hoekstra, confirmed plans to present an EU climate target for 2040 on July 2, during a meeting with EU countries’ representatives on Wednesday, diplomats familiar with the closed-door talks told Reuters.
The proposal will set an EU goal to cut net greenhouse gas emissions 90 percent by 2040, compared with 1990 levels, the diplomats said. However, the EU executive plans to add flexibilities to that target, which could reduce what it demands from domestic industries.
The flexibilities include setting an emissions-cutting target for domestic industries that is lower than 90 percent and letting countries buy international carbon credits to make up the rest, to reach 90 percent, the diplomats said.
A European Commission spokesperson declined to comment on the plans.
The Commission has promised not to weaken Europe’s ambitious climate aims, despite mounting criticism from governments and lawmakers concerned about the cost for European businesses, which are struggling with high energy prices and looming US tariffs.
Europe is the world’s fastest-warming continent. The Commission has delayed its 2040 climate proposal for months, and has weakened other green laws in recent months to try to calm the political pushback.
EU countries are split over the 2040 goal, which they and EU lawmakers must approve. Finland, the Netherlands and Denmark are among those backing a 90 percent emissions cut. Opponents include Italy and the Czech Republic.
Germany has backed a 90 percent target if countries can use international carbon credits to meet three percentage points of the goal.
The Commission is also considering softening requirements for countries to cut emissions in specific sectors — giving them more choice over which industries do the heavy lifting to meet the goal, the diplomats said.
The 2040 goal will aim to keep EU countries on track between their 2030 emissions target — which they are nearly on track to meet — and the EU’s aim to reach net zero emissions by 2050.


Death toll in central Nigeria floods rises to 36: rescuers

Updated 56 min 39 sec ago
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Death toll in central Nigeria floods rises to 36: rescuers

KANO: The death toll in central Nigeria flash floods has risen to 36 after rescuers recovered more bodies, an emergency services spokesman told AFP Friday.
Flooding after torrential rains late on Wednesday washed away more than 50 homes in the city of Mokwa in central Niger state, drowning residents with many missing, according to the Niger state emergency management agency (SEMA).
“As at this morning, 11 more bodies were recovered in addition to the 25 found earlier, which brings the number of fatalities to 36 so far,” Ibrahim Audu Husseini, SEMA spokesman said.
Teams of rescuers continued to search for missing residents into Friday.
“We expect the toll to rise considerably because there are different rescuers at different locations,” Husseini said.
Nigeria’s rainy season, which usually lasts six months, is just getting started for the year. Scientists warn that climate change is already fueling more extreme weather patterns.
Flooding, usually caused by heavy rains and poor infrastructure, wreaks havoc every year, killing hundreds of people across the west African country.
In Nigeria, the floods are exacerbated by inadequate drainage, the construction of homes on waterways, and the dumping of waste in drains and water channels.
The Nigerian Meteorological Agency had warned of possible flash floods in 15 of Nigeria’s 36 states, including Niger state, between Wednesday and Friday.
In 2024, more than 1,200 people were killed and 1.2 million displaced in at least 31 out of Nigeria’s 36 states, making it one of the country’s worst floods in decades, according to the National Emergency Management Agency.


New Zealand defense minister pledges more deployments, co-operation

Updated 30 May 2025
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New Zealand defense minister pledges more deployments, co-operation

  • Judith Collins raises the prospect of welcoming increased warship visits to the country, deepening joint training and other cooperative efforts

SINGAPORE: New Zealand is seeking to expand Asia-Pacific military deployments in its quest to show it was now “pulling our weight” with increased spending on its armed forces, the South Pacific nation’s defense minister said in Singapore on Friday.

Defense minister Judith Collins raised the prospect of welcoming increased warship visits to the country, deepening joint training and other cooperative efforts with its traditional defense partners including ally Australia, the United States, Singapore, Japan, Britain and the Philippines.

“So we’re open for business, we’re back in the world and we’re pulling our weight,” Collins said on the sidelines of the Shangri-La Dialogue defense meeting in Singapore.

The New Zealand government announced in April that it would boost defense spending by NZ$9 billion ($5 billion) over the next four years, with the aim of nearly doubling spending to 2 percent as a share of gross domestic product in the next eight years amid growing international tensions.

The new spending is a significant boost to the defense budget of just under NZ$5 billion in 2024/25, and follows its first national security review in 2023.

The review called for more military spending and stronger ties with Indo-Pacific nations to tackle issues of climate change and strategic competition between the West, and China and Russia.

The USS Blue Ridge, the command ship of the US Pacific Fleet, visited Wellington earlier this month and further visits from partners could be expected, Collins said. The ship was just the third US warship to visit in 40 years.

When asked about Chinese concerns at New Zealand’s more assertive military posture, she said Beijing realized Wellington had “actually got a spine,” but “I don’t think China stays awake at night worrying about us.”

“I don’t think we’re any threat to China, or anyone else really,” Collins said, describing relations with China, an important trading partner, as “very mature.”

Regional military attaches and analysts say that after years of relative neglect, New Zealand still had to improve its ability to sustainably project power given its small, aging navy and air force but supporting its traditional relationships were key.

Nuclear-free since the 1980s, New Zealand maintains an independent foreign policy but remains part of the Five Eyes intelligence sharing network with the United States, Britain, Australia and Canada.

Deployments of its four new Boeing P-8 Poseidon maritime patrol aircraft are being closely watched, given how they can help other countries plug gaps in the hunt for Chinese submarines, analysts say.

Collins said New Zealand and Australian pilots now had the ability to fly each other’s P-8 and transport planes — a sign of growing “interoperability” in action.

Collins said the P-8s had already flown up toward Canada and she expected further patrols in the South China Sea and Indian Ocean. “I think you’ll see quite a lot of that,” she said. “We go everywhere. Everywhere where we’re wanted we go, if we can.”


Ukraine, Russia ‘want ceasefire,’ Turkiye FM says en route to Kyiv

Updated 30 May 2025
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Ukraine, Russia ‘want ceasefire,’ Turkiye FM says en route to Kyiv

  • Hakan Fidan: ‘I observe that the issue is beginning to take a more optimistic turn as negotiations start’

ANKARA: Russia and Ukraine both want a ceasefire to halt three years of war, Turkiye’s top diplomat said on Friday as he headed to Kyiv after holding talks in Moscow.

“I observe that the issue is beginning to take a more optimistic turn as negotiations start. Both parties want a ceasefire. No one says they don’t want it,” Foreign Minister Hakan Fidan said on the train taking him to Kyiv, reported news agency Anadolu.