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Lack of consensus on obstetric practices between countries of the European Union

The rate of caesarean deliveries varies considerably throughout Europe, according to a new study from the EURO-PERISTAT project, published in BJOG: An International Journal of Obstetrics and Gynaecology.

We know that the likelihood of a caesarean delivery is greater for women in their first pregnancy, for women who have already had a caesarean section, and for women carrying twins or a baby in breech presentation. This study shows for the first time that these differences vary greatly from one country to another. For example, fewer than 50% of multiple births in Norway, Iceland, Finland and the Netherlands are by caesarean delivery, whereas this percentage reaches 90% in Malta and Cyprus. Similarly, fewer than three-quarters of breech births in Norway and Sweden are by caesarean delivery, in contrast to over 90% in the Czech Republic, Germany, Italy, Cyprus, Luxembourg, Malta, Scotland, Iceland and Switzerland.

France occupies an average position relative to the other countries, with a rather low overall caesarean rate, 21%.

According to the study’s conclusions, additional research is needed to explain the reasons for these differences, particularly by studying the impact of international differences in the organisation and funding of health systems and in the attitudes of parents and professionals regarding care at the time of delivery.

The EURO-PERISTAT project (http://www.europeristat.com/) is a collaboration between 26 Member States of the European Union, together with Norway, Iceland and Switzerland. It is led by Jennifer Zeitlin, a researcher at the French National Health and Medical Research Institute (Inserm), Obstetrical, Perinatal, and Pediatric Epidemiology Research Team (EPOPé) (http://www.epopé-inserm.fr/).