Share of Caesarean section births declined slightly

Increasing number of deliveries and a lower proportion of Caesarean section births
After the proportion of Caesarean section births has risen continuously over the years, according to the Federal Statistical Office there was a slight decrease in the Caesarean section rate in 2015. A trend reversal may be emerging here, which in turn leads to a higher proportion of natural births, as experts have long been demanding. The number of hospital deliveries rose overall in 2015, which also gives hope for a change in demographic trends.

A total of 716,539 hospitalizations were recorded in 2015. An increase of 3.5 percent over the previous year (24,626 births). The times of continuously falling birth rates seem to be over. More women have also opted for natural delivery. The proportion of women who gave birth by caesarean section decreased slightly compared to 2014 by 0.7 percentage points to 31.1 percent, according to the Federal Statistical Office (Destatis).

Different Caesarean section rates in the individual federal states
In the past few years, more and more caesarean section births have been identified, although there was often no medical need for such delivery. In 2015, the share of Caesarean sections in hospital deliveries has decreased slightly. However, almost every third child is born by Caesarean section. However, there are clear differences between the individual federal states. The Caesarean section rates in the Saarland were extremely high (38.5 percent), while Brandenburg (25.6 percent) and Saxony (24 percent) had a very low proportion of Caesarean section births.

North Rhine-Westphalia with the most deliveries
Contrary to the declining trend, the proportion of Caesarean sections in Hamburg and Saxony-Anhalt has risen slightly (+ 0.7 and + 0.5 percentage points, respectively), according to the Federal Statistical Office. Hamburg thus has the second highest cesarean birth rate in Germany. North Rhine-Westphalia had by far the highest number of hospital deliveries (157,065 births), followed by Bavaria (114,909 births). Most absolute Caesarean sections were performed here (50,164 or 36,595).

Other obstetrics are rare
In addition to the caesarean sections, other obstetrics were used relatively rarely in 2015. "A suction cup (vacuum extraction) was used in 5.9% of the deliveries, birth forceps in 0.4% of the deliveries," reports the Federal Statistical Office. As in the previous year, the proportion of children born alive was 99.7 percent.

Midwifery Association calls for strengthening of natural birth
The German Midwifery Association (DHV) expressed considerable criticism of the still high proportion of Caesarean section births and called for "strengthening the physiological birth". According to the World Health Organization (WHO), only a Caesarean section rate of up to 10 percent is medically necessary. There is an urgent need for action here to lower the Caesarean section rate in Germany. "Because every caesarean section is an operation and should only be performed if it is medically necessary," said the association.

Caesarean section rate must be reduced
"The Caesarean section rate in Germany is too high and needs to be reduced," emphasizes Susanne Steppat, member of the DHV Presidium. The expert cites shortage of staff in the delivery rooms as a reason for the high proportion of these births, which prevents them from being able to take intensive care of every woman giving birth. There is also “meanwhile too little knowledge about the different courses of a normal birth.” Today, “the slightest deviation from gynecologists often intervenes,” says Steppat. There would be no valid standards for when a caesarean section is necessary. The decision is therefore made in many cases subjectively, also with the fear of mistakes and subsequent birth defects.

Risks for mother and child
Cesarean sections can save lives, but they should only be used in an emergency, the midwives' association demands. Because the intervention entails risks for the health of mother and child. For example, there is an increased risk of asthma, diabetes and allergies for the children as a result. "A nationwide action plan to promote the physiological birth would be the right signal," according to Steppat. (fp)

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