Caesarean section rates in government hospitals in Malaysia, 2000-2001.

There has been widespread concern about rising caesarean section rates in the world. Various reviews have documented the wide variation worldwide in caesarean rates. For instance, in the mid-to-late 1980s the caesarean rate was 32% in Brazilian states, 25% in the United States, 5% in Jamaica and 7% in Czechoslovakia!. It is believed that the rising trend is due to the general trend towards lowering the threshold for caesarean section for all indications and the resulting rise in repeat caesarean deliveries are the reasons for most of the observed increase3. Currently there also seems to be some controversy about caesarean section performed on the request of the mother. One unit reported a rate of 1 in 200 or 0.5% of caesarean section on maternal request alone with no other contributing factors4•