Cesarean Section Beyond Cesar’s Borders: A Mini Review on the Cultural History of Cesarean Section High Prevalence Rates in the Middle East

Abstract

Cesarean section rates have risen significantly in some Middle Eastern countries like Iran, Turkey, and Egypt. Therefore, this review aims to investigate the cultural background for the high cesarean section rates in some Middle Eastern countries to provide the obstetricians and policymakers a better perspective on the crisis. Firstly, the dimensions of the current crisis in the Middle East are discussed. Then, three famous medieval authors are investigated; Ferdowsi (Shahnameh; the birth of Rostam, the Persian superhero, through the cesarean section), Abu Rayhan Biruni (The Remaining Signs of Past Centuries), and Ibn Abi al-Hadid. All these medieval sources try to teach how proud is the one who is born through a cesarean section, and thus a person born vaginally is of a lower rank and therefore less respected. Then, the influencing ancient resources dealing with this subject are reviewed: the birth of Asclepius, the Greek god of medicine, by his father Apollo through a section on the mother’s corpse, and Talmud of the Jews. In ancient times, a birth through the cesarean section was a pure birth, or a gift from gods and restricted to divinities. Hoping to gain a new and comprehensive understanding of this current crisis in the Middle East, the World Health Organization (WHO) guidelines on reducing the prevalence of cesarean section are subsequently introduced. The C-section prevalence has increased significantly in the Middle East; comprehensive national, regional, and international policies are highly demanded.

Keywords: Cesarean Section, Maternal Mortality, Middle East, Obstetric Delivery, Prevalence