On 2016 Jul 24, Judy Slome Cohain commented:

I just was sent a paper to peer review, which cited this paper to prove that higher cesarean rates (over 20%) are not associated with higher maternal mortality. This paper does not show that. This paper definitely shows direct relationship between maternal mortality and cesarean. It also appears that maternal mortality increases with low CS rates because the poorest countries happen to have both low cesarean rates and high rates of maternal mortality for all kinds of reasons unrelated to cesarean rates. All research shows the death rate from all major abdominal surgery due to hemorrhage or anesthesia is still a steady 1 in 10,000. Do more cesareans, more women die.

On 2016 Jul 24, Judy Slome Cohain commented:

I just was sent a paper to peer review, which cited this paper to prove that higher cesarean rates (over 20%) are not associated with higher maternal mortality. This paper does not show that. This paper definitely shows direct relationship between maternal mortality and cesarean. It also appears that maternal mortality increases with low CS rates because the poorest countries happen to have both low cesarean rates and high rates of maternal mortality for all kinds of reasons unrelated to cesarean rates. All research shows the death rate from all major abdominal surgery due to hemorrhage or anesthesia is still a steady 1 in 10,000. Do more cesareans, more women die.