C-Section Rate Down 11%, But Still High

The rate of delivery via cesarean section among Iranian women is still four times higher than the World Health Organization (WHO) recommendation.

Since 1985, the WHO has considered the ideal rate for c-section to be between 10-15% of all childbirths. Only in medical emergencies, can cesarean birth effectively prevent maternal and newborn mortality, says the global health watchdog.

Two studies conducted by the WHO have indicated that when c-section rates rise to 10% across a population, the number of maternal and newborn deaths decreases. But when the rate goes above 10%, there is no evidence that mortality rates improve.

“Since the 2014 Health Reform Plan, 1.5 million natural births were performed free-of-charge in state-run hospitals across the country.

 In the same period cesarean births reduced by 11.6%, reaching 41% in 2016 from 56.5% in 2013,” said Health Minister Seyed Hassan Qazizadeh Hashemi on Friday, during a visit to Emdad-e-Shahid Beheshti Hospital in Sabzevar city, Khorasan Razavi Province.

Pointing to the considerable reduction in c-section rates he said, “Establishment of labor-delivery-recovery (LDR) rooms and making natural delivery free in all state-run hospitals, were two important strategies of the ministry in bringing down c-section deliveries.”

He added that this year, the ministry plans to establish more LDR rooms to come closer to the WHO recommendation.

Earlier this year, Ali Maher, the ministry’s technical treatment deputy had said that since the year 2014, more than 1,400 LDR rooms were established in state-run hospitals across the country. “In line with efforts to promote natural delivery, in the previous fiscal year (ended March 20), natural childbirth classes were held for 500,000 expectant mothers.”

This year there are plans to establish 1,800 more LDR rooms at state hospitals.

LDR rooms are private rooms where women can give birth and stay for 2 hours after delivery. They were set up in 350 hospitals with the aim to encourage natural births by providing a pleasant, private environment for mothers-to-be. “These rooms now number 2,022 across the country,” Amir Saki, director general of the ministry’s physical resources and development management office, had said earlier.

   Maternal Deaths

Currently, the maternal mortality rate (MMR) is 19 per 100,000 live births in the country. The figure was 25 per 100,000 two years earlier. With a 96% decrease in MMR from 1990-2016, Iran is ranked the third most successful country in the Middle East after Oman and Lebanon in bringing down the rate.

Maternal death is defined by the WHO as “the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes.”