From data obtained from the World Health Organization, the pattern of Stillbirth Rates versus Caesarean Section Rates indicate a trimodal pattern broadly divided into three groups. The three groups can be differentiated from the varying stillbirth rates in various countries 

Group A Stillbirth rates of 2 - 4/1000 live births,

Group B Stillbirth rates of 4.1 - 12/1000 live births and

Group C Stillbirth rates of 12.1 - over 30 stillbirths /1000.

The maximum stillbirth rate recorded was 46.7/1000 in Pakistan.

Group A (Stillbirth rates of 2- 4/1000 live births) are well developed countries with adequate prenatal and neonatal care. Group B are countries that have Caesarean Section rates above 15% but have stillbirth rates of 4.1 - 12/100 live births possibly due deficencies in healthcare systems including neonatal care. Group C (Stillbirth rates of 12.1 - over 30 stillbirths /1000) are in the main underdeveloped countries with Caesarean Section rates lower than 10% and where prenatal care may also be deficient. None of the countries with stillbirth rates of 2- 4 /1000 have a Caesarean Section rate between the World Health Organization recommended 10-15% thresholds.

With Regards,
Sara Giselle
Associate Managing Editor
 Journal of Critical Care Obsestrics & Gynocology