palisade 13 hours ago

"The cesarean delivery rate increased from 5% in 1970 to 31.9% in 2016. This sharp increase can be attributed to various factors, including changes in maternal age, medical advancements allowing more complicated pregnancies to proceed, and evolving obstetric practices. In 2022, the United States recorded more than 3.66 million births, most of which resulted from spontaneous or induced labor. Labor dystocia remains the most common indication for primary cesarean delivery. Globally, cesarean delivery rates continue to rise, and reducing unnecessary cesarean procedures remains a priority in the United States, where 32.2% of all births in 2022 were cesarean deliveries."

https://www.ncbi.nlm.nih.gov/books/NBK546707/

"If this trend continues, by 2030 the highest rates are likely to be in Eastern Asia (63%), Latin America and the Caribbean (54%), Western Asia (50%), Northern Africa (48%) Southern Europe (47%) and Australia and New Zealand (45%), the research suggests."

https://www.who.int/news/item/16-06-2021-caesarean-section-r...

Note: Coincidentally, WHO's article I've linked is lamenting that Sub-saharan Africa only had 5% cesarean due to less availability of the procedure. It is their perspective that the increase in percentages is a good thing and indicates progress, instead of being concerning. And, they find Sub-saharan Africa's low numbers concerning, instead.

Side Note: I also found lots of interesting articles which I haven't posted here, about epigenetic side effects caused by caesarean deliveries like leukemia, illnesses and other genetic issues. But, that seems out of scope for your question. You can make a quick search and find these, though.

"A female-to-female familial predisposition to caesarean section was observed. It could be caused by biologic inheritance, primarily working through maternal alleles and/or environmental factors. The results imply that both mechanisms could be important."

https://pubmed.ncbi.nlm.nih.gov/18540028/

"Large-scale epidemiological studies indeed evidence that women born by C-section are more likely to deliver by Caesarean than women born vaginally, owing primarily to genetic rather than social factors."

https://www.pnas.org/doi/10.1073/pnas.1712203114

2
rkangel 13 hours ago

Interesting - thank you!

squigz 12 hours ago

> Another Note: Also, ironically WHO's article I've linked is lamenting that Sub-saharan Africa only had 5% cesarean due to less availability of the procedure. It is their perspective that the increase in percentages is a good thing and indicates progress, instead of being concerning. And, they find Sub-saharan Africa's low numbers concerning, instead.

Pretty sure their perspective is that "saving the lives of mothers and babies" indicates progress.

> While a caesarean section can be an essential and lifesaving surgery, it can put women and babies at unnecessary risk of short- and long-term health problems if performed when there is not medical need.

> Rather than recommending specific target rates, WHO underscores the importance of focusing on each woman’s unique needs in pregnancy and childbirth.

> WHO recommends some non-clinical actions that can reduce medically unnecessary use of caesarean sections, within the overall context of high quality and respectful care:

palisade 11 hours ago

Yes, that's what they're indicating. And, it is saving lives. I myself was cesarean section, as was my mother. I wouldn't be here without it.

That's the potential conundrum, if it turns out to be vastly increasing the need to save those lives than in the past due to a evolutionary pressure on the gene pool. If the WHO is right and we're going to start seeing 50 - 63% increases by 2030, what's in store for the human race if this rate of expansion keeps up?

Will we reach a time when no one can be naturally born and almost our entire race has to be conceived in external gestation devices or cease to exist? And, when we reach that point will we look with concern towards Africa and wonder at how sad it is they're still conceived naturally.

Edit: I don't have the answers. I'm not sure what we should do to course correct or if we need to. But, it is definitely something that should be looked into before it is too late, if it isn't already. And, that is why I brought it up in the context of this breakthrough, to ask if we've considered similar consequences. And, if we have a way to mitigate them if that turns out to be the case.

squigz 11 hours ago

> Edit Edit: I can't reply to your comment below I think we've hit the leaf end of this post. But, to reply to your question are c-sections replacing natural births or are they just becoming more common? The research I've cited has indicated this is a genetic transfer among female-to-female births of a need for more cesareans.

To reply after a certain number of child comments, you have to open the comment by clicking the timestamp thing

I'm also afraid I don't understand your response. Can you elaborate?

palisade 11 hours ago

Thanks, I replied to your other comment.

squigz 11 hours ago

Are c-sections replacing 'natural' births, or are they simply becoming more common because we have the expertise? There is a difference

palisade 11 hours ago

The research I've cited has indicated this is a genetic transfer among female-to-female births of a need for more cesareans.

"A female-to-female familial predisposition to caesarean section was observed. It could be caused by biologic inheritance, primarily working through maternal alleles and/or environmental factors. The results imply that both mechanisms could be important."

https://pubmed.ncbi.nlm.nih.gov/18540028/

"Large-scale epidemiological studies indeed evidence that women born by C-section are more likely to deliver by Caesarean than women born vaginally, owing primarily to genetic rather than social factors."

https://www.pnas.org/doi/10.1073/pnas.1712203114

squigz 10 hours ago

> "Large-scale epidemiological studies indeed evidence that women born by C-section are more likely to deliver by Caesarean than women born vaginally, owing primarily to genetic rather than social factors."

Interesting. That makes sense. I wonder if the type of research being pursued in TFA might be helpful.

In any case, I also have to wonder whether it's necessarily a bad thing. I quoted 'natural' births earlier because... what is natural? The amount of medical knowledge and technology that go into births doesn't seem very "natural" to me, and this has advanced through the ages to where we are now - where we, rightfully so, look sadly on areas where lack of such technology and knowledge result in more preventable deaths of babies, even if their methods are more "natural"

Of course, to be honest, I'm not very familiar with the pros and cons of c-sections vs natural births - particularly when the question is whether to have a child. I suppose that, given the choice between a c-section and the alternatives, most women will opt for a c-section, and as you point out, that means their daughters likely will have to as well

So what might the solution even look like, apart from exploring the aforementioned gene-editing technology - or other technology - to prevent the genetic factor of c-sections? I would hope that "don't offer c-sections" is not a serious option. "Stop having kids" is one I'd personally suggest, but that's obviously not a sane global solution either.

It's an interesting problem I'd be curious to hear more about - as I said, I'm not very familiar with this.