Cesarean section and different circumstances of the obstetric field among countries

摘要

I read the Michelsen et al. (1) and Eskildd and Grytten's (2) comments regarding cesarean section and fetal death rates. Cesarean section is an important topic among obstetricians worldwide. Michelsen stated that cesarean section is not related to perinatal mortality (1). This may imply that declining fetal death rates are not caused by increases in cesarean section rates. They also claimed that cesarean section is associated with man)' more complications than vaginal birth, such as postpartum hemorrhage, infection, and hysterectomy (1). I agree somewhat with the letter by Michelsen et al. (1). However, I have also stated that different countries, such as Korea, have different health care systems and the impact of the claim made by Michelsen on other countries should be considered (1).