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[Comment] Appropriate use of caesarean section globally requires a different approach

Increasing global rates of caesarean section are debated because of evidence that medically unnecessary caesarean sections are associated with worse outcomes for mothers and their children.1 There is consensus that caesarean sections are overused in some countries and underused in others. As Ties Boerma and colleagues2 report in this Lancet Series on optimising caesarean section use,1–3 there are unacceptable disparities: caesarean section rates of 44% in Latin America and the Caribbean compared with 4·1% in western and central Africa.

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