Brazil (52% caesarean section rate in 2010)150 and urban China
(54–64% caesarean section rate in 2008–2010)151,152 are two
contexts where rapid economic growth in recent years has been
accompanied by extraordinary increases in interventions, most
notably caesarean sections, with growing concerns in each
country over the medicalisation of birth and corresponding
potential links with an increased maternal or perinatal
mortality and morbidity. A 2010 study for WHO153 identifi ed the
two countries as fi rst and second in a global ranking of
unnecessary caesarean sections, China: 1 976 606 and Brazil
960 687, with a combined cost per year of over US$553 million.
This occurrence has been termed ”unnecesareans” in Brazil.154