VANCOUVER, B.C. – Cheese wraps, urine poultices, cell cures – when it comes to injuries, elite athletes can be game for some pretty out-there therapies.

That propensity came to light this week when U.S. Alpine skiing star Lindsey Vonn, widely predicted to be the “It Girl” of the Vancouver Games, announced she had been wrapping her right leg in cheese – a European curd cheese – to treat a deep bruise that could stand between her and Olympic glory.

The therapy, from which the U.S. Olympic team’s chief doctor quickly distanced himself, was administered in Austria. That’s where Vonn sustained her injury and where the curd cheese, topfen, is apparently hailed for anti-inflammatory properties.

There doesn’t appear to be any scientific evidence to suggest the cheese has those or any other medicinal powers. PubMed.gov, an online database of published medical studies maintained by the U.S. National Library of Medicine, draws a blank in a search for “topfen.”

But that hasn’t stopped other members of the U.S. ski team from trying the cure, which is also, a Google search reveals, used to treat mastitis, a painful inflammation of breast tissue that sometimes afflicts breastfeeding women.

“I don’t have a lot of experience with it. I know a lot of the athletes on the U.S. ski team . . . have had a good experience with it,” Dr. Bill Sterrett, the team’s physician, said with no audible note of cynicism Wednesday.

Sterrett certainly wouldn’t be the first physician looking after athletes to be asked to administer, endorse or at least oversee a therapy that’s not taught in medical schools.

“I’ve heard of stranger,” Dr. Bob McCormack, chief medical officer for the Canadian Olympic team, said Thursday when asked about Vonn’s cheese nostrum.

“I remember one of our athletes coming to a previous Games, a young athlete who was told by her coach, for her sprained ankle, what she needed to do was urinate in a rag and wrap her ankle in the urine-soaked rag.”

“The idea was the uric acid would drain out the swelling. That’s an example of something that’s been used in Eastern Europe, a little bit more in the past,” said McCormack, who is an orthopedic surgeon from Vancouver.

McCormack said while he sees no reason why poultices of curd cheese or the urine equivalent of a mustard plaster would help speed recovery of a bruised shin or a sprained ankle, he doesn’t object if the remedy isn’t going to make the injury worse or trip a positive doping test.

“For me, the issue is, ‘Will it do harm to the athlete and is it performance enhancing from the WADA perspective?’ he said, referring to the World Anti-Doping Agency. “Cheese curd falls into neither of the those (categories).”

“I can’t see it doing any harm and if the athlete believes in it, I am OK with it,” he added, noting there are lots of such remedies in use.

The willingness of Sterrett and McCormack to go along with treatments that seem at odds with evidence-based medicine probably lies in the latter’s comment about an athlete’s faith in a given remedy.

People who treat elite athletes agree the placebo effect is strong in this highly motivated group of individuals.

Sometimes, though, the remedies they latch on to aren’t as benign as curd cheese and urine soaked rags.

Dr. Harm Kuipers, a physician and professor of exercise physiology at the University of Maastrict in the Netherlands, once treated a cyclist who sought Kuipers’ help when he developed symptoms of having over-trained.

There was no obvious explanation for his decline in performance and the problem was a mystery until the man noted in passing that his symptoms started around the time he had what he called a “cell cure.”

From what Kuipers could tell, the man had had a series of injections of some unidentified animal proteins. After the first, he felt fine. After the second, he felt a bit uncomfortable. After the third, the man told Kuipers, he felt very sick and actually thought he was going to die.

“I said, ‘Well, congratulations, you had an anaphylactic shock,”‘ Kuipers said, referring to a form of severe allergic reaction that can be fatal.

Said Kuipers: “I’ve seen and heard a lot of strange and crazy things.”

Canadian figure skater Patrick Chan knows about injuries. But when he injured his calf last fall, he couldn’t test out the cheese cure. He didn’t know about it.

“I’d be too hungry, I’d eat the cheese before I’d let it settle.” he quipped Thursday. “I’ve never heard of that. It sounds cool though.”

-with files from Donna Spencer and Lori Ewing in Vancouver

WASHINGTON – A critical safety net for babies – that heelprick of blood taken from every newborn in the U.S. – is facing an ethics attack.

After those tiny blood spots are tested for a list of devastating diseases, some states are storing them for years. Scientists consider the leftover samples a treasure, both to improve newborn screening and to study bigger questions, like which environmental toxins can harm a fetus’s developing heart or which genes trigger childhood cancers.

But seldom are parents asked to consent to such research – most probably do not know it occurs – raising privacy concerns that are shaking up one of public health’s most successful programs. Texas is poised to throw away blood samples from more than five million babies to settle a lawsuit from parents angry at what they call secret DNA warehousing. A judge recently dismissed a similar lawsuit in Minnesota.

Michigan just moved four million leftover blood spots into a new “BioTrust for Health,” planning a public education campaign about the research potential and how families can opt out.

Advisers to the U.S. government hope to have national recommendations in two months on how to assure all babies still get their newborn tests while allowing parents more say in what happens next.

“It’s a critical thing that we take action,” says advisory board member Sharon Terry of the non-profit Genetic Alliance. She says distrust over the leftover blood spots threatens public confidence in newborn screening itself.

“The sunshine on the information – educating parents – is the way lesser threat. Done well and done right, there will be an enormous benefit overall to the system,” she says.

Newborn screening is not new. It began in the 1960s, and today every baby is supposed to be tested for at least 29 rare genetic diseases in hopes of catching the fraction who need early treatment to help avoid brain damage or death. Now being added to the list: Bubble-boy disease, formally known as SCID for severe combined immune deficiency.

The program catches about 5,000 babies a year in need of treatment.

Because newborn screening is mandatory, only a handful of states provide much upfront parent education. Leftover spots mainly are used for double-checking that newborn tests are accurate. Sometimes, families ask geneticists to study them after a child’s death from a disease doctors can’t immediately diagnose.

But as scientists sought to use the leftovers for broader research, suddenly the informing of parents – especially about long-stored spots – became an issue. While blood spots are stripped of identifying information before being handed over to scientists, people generally need to consent to participate in research.

“My kid is not a lab rat. You have to ask before you can use him in an experiment, before you can use his blood, his tissues, his DNA, whatever,” says Andrea Beleno, one of the Texas parents who sued. Among their worries: that genetic information about the children could fall into the wrong hands.

Had she only been asked, Beleno adds, she probably would have let her son’s blood spot be stored.

To scientists who pore through dusty warehouses in search of blood samples stored by health department ID codes – not the babies’ names – privacy concerns are exaggerated.

“There’s a gap between the name and the DNA. … There’s no way one could just put one’s hands on these blood spots and know anything about that person,” says Dr. Christopher Loffredo of Georgetown University, who needed families’ permission to cull about 1,200 blood spots stored in Maryland for a study that linked a pregnant woman’s smoking or exposure to certain chemical solvents to fetal heart defects.

Still, Dr. Jennifer Puck of the University of California, San Francisco, who created the new SCID test using leftover blood spots, understands parents’ concerns.

“DNA is your personal signature, and it uniquely identifies us,” Puck says. “We all have to become more careful and more specific in terms of what we’re going to do with the blood spots.”

Bioethicist Aaron Goldenberg of Case Western Reserve University studied parent attitudes, and found three-quarters would be willing to have their baby’s leftover blood spot used for research if they were asked first. But they generally oppose that research without consent.

The balancing act for states, he says, is separating the two issues – lifesaving newborn screening and other use of the leftover blood – in the little time available to educate parents.

MONTREAL – Dorel Industries’ (TSX:DII.B) reputation took another hit Friday after transportation safety agencies in Canada and the United States disclosed a “potential problem” with nearly 30,000 infant car seats.

The problem involved a faulty spring that could cause Maxi-Cosi Mico infant seats made in 2008 to not lock fully when installed into their removable base.

With no consumer complaints or reported injuries, the recall on its own is a hiccup for the world’s largest car seat manufacturer.

But, it is the latest of a half dozen recalls of seats, cribs and baby gates over the past few months has raised questions about Dorel’s design and manufacturing of children’s products.

“It’s not like we have a systemic quality control issue, we don’t,” spokesman Rick Leckner said in an interview.

The Montreal-based company uses hundreds of quality control people, including 200 in China, to ensure its products are safe. However, occasionally a few problems slip through, Leckner said.

He said Dorel works hard to make sure that its products are as fool proof as possible, especially because they involve the safety of children.

Industry observers fear the recall could spook parents from purchasing Dorel products and have a cumulative effect on the company’s reputation.

It’s a risk that Dorel is aware of as it reassures parents while attempting to avoid undue panic when it sends recall notifications.

“You’re reputation is your No. 1 asset and you have to do everything you can to protect it and it starts with making the best possible product,” Leckner.

He said the industry also has to do a better job explaining to parents about the proper assembly and use of products to prevent injuries.

Testing by Transport Canada found that the seat could separate from its base during a collision.

It said the car seats, manufactured in Columbus, Ind., between March 8 and June 28, 2008, can still be used but owners should check that a release handle is pushed in properly and fully locked.

Dorel will notify registered owners and send a repair kit which includes two replacement springs.

The recall involves less than 7,000 seats in Canada and 22,850 in the United States. The company will repair the 400 seats still sitting on store shelves.

“Fortunately there have been no incidents at all, no injuries and this is purely a precautionary move that has been taken,” said Leckner.

Dorel shares closed at $31.29, up 11 cents Friday on the Toronto Stock Exchange.

BEIJING – Three dairy plant managers and one milk powder dealer in central China have been arrested for allegedly selling milk products tainted with the industrial chemical melamine, shortly after the government launched a 10-day crackdown.

The chemical, which is used to manufacture plastics and fertilizer, became a household name in China in 2008, when six children died and 300,000 were sickened after drinking tainted baby formula. Dozens of officials, dairy executives and farmers were punished, and Beijing vowed to implement stricter safety measures and step up inspections of the industry.

Lekang Dairy Company general manager Zhang Wenxue and vice general managers Zhu Shuming and Tong Tianhu have been charged with manufacturing and selling tainted milk powder in the latest crackdown, the official Xinhua News Agency reported Wednesday.

Ma Shuanglin, a milk powder dealer who worked with Lekang in distributing the suspected tainted products, was also arrested, Xinhua said. The dairy, which was among the companies named in the 2008 scandal, is located in Weinan city in the central province of Shaanxi.

The report said the men are suspected of overseeing an operation in which untainted milk powder was mixed with melamine-infused powder. Melamine can be added to diluted milk products as a way to fool quality control tests for protein levels. This allows unscrupulous dairies to stretch their profits.

Melamine can have dire effects when ingested, including causing kidney stones and kidney failure.

Concerns about tainted milk products peaked again early this year after authorities in Shanghai said they secretly investigated a dairy for nearly a year before announcing it had been producing tainted products.

The case was especially troubling because Shanghai Panda Dairy Co. was one of the 22 dairies named by China’s product safety authority in the 2008 scandal, with its products having among the highest levels of melamine.

As part of the current 10-day crackdown, “all melamine-tainted milk products will be found and destroyed,” Xinhua quoted Health Minister Chen Zhu as saying.

In January, tainted dairy products from three companies that had somehow made it back on store shelves were pulled from more than a dozen convenience stores around the southern province of Guizhou.

In December, the general manager of a dairy in northern Shaanxi province and two employees were accused of producing and selling more than five tons of tainted milk powder. Xinhua reported that none of the tainted powder had reached the market.

Melamine-tainted milk products were also recently found in the provinces of Shaanxi, Shandong, Liaoning and Hebei.

Northern leaders say Prime Minister Stephen Harper should look to the Arctic if he wants to improve the health of newborn children.

“We’re hopeful he’ll tackle this issue in his own backyard,” Pita Aatami, head of Makivik Corp. which oversees the land claim of Inuit in Quebec, said Friday.

“If you’re going to talk the talk, you might as well practise it in your own country.”

On Thursday, Harper repeated his pledge before international leaders in Davos, Switzerland, to make child and maternal health in developing nations a priority at the G8 summit in Canada later this year.

It’s a note Harper has been hitting all week. In an op-ed piece published in Canadian newspapers Tuesday, the prime minister said the health of young children and mothers in many places is “not acceptable.”

“The solutions are not intrinsically expensive,” he wrote. “The cost of clean water, inoculations and better nutrition, as well as the training of health workers to care for women and deliver babies, is within the reach of any country in the G8.”

But the day before Harper’s article was printed, two major studies were published showing that Inuit infant mortality is nearly four times the Canadian average and 70 per cent of Inuit preschoolers live in homes where there isn’t always enough food.

In Aatami’s home community of Nunavik, in northern Quebec, the infant mortality rate is 18.1 per 1,000 babies born, almost the same as the rate in Mexico.

In a blog post Friday, the head of Canada’s national Inuit group pointed out the contradiction. Mary Simon of Inuit Tapirisat Kanatami wrote: “(We) question why, if these solutions are not expensive, and are ‘within the reach of any country in the G8,’ the situation in (the) Inuit (homeland) remains what it is today?

“Canada, as one of the eight most prosperous countries in the world, has a significant responsibility in assisting those in the world’s poorest regions. We hope the Inuit region in Canada is included on a similar list to take care of the issues inside our own country.”

There was no immediate response from federal officials.

Inuit children have the highest rate of hospital admission for lower respiratory tract infections in the world. The rate of premature delivery is three times what it is in the south. Many Inuit youngsters live in overcrowded, substandard homes.

Inuit suicides – 43 per cent of which are committed by youth under the age of 20 – are 11 times more common than the Canadian average.

Aatami said he’s written a letter to Indian and Northern Affairs Minister Chuck Strahl asking if Harper’s statement means the Inuit can expect to see more action on their concerns.

“We’re hopeful, after that announcement, that (Harper) wants to tackle this issue,” Aatami said. “Canada, being one of the richest G8 countries, should have some money for its own backyard. I’m hopeful they’ll do something.”

The federal government does fund maternal and infant health programs for Inuit. It also runs programs to try to reduce the incidence of diseases such as diabetes and tuberculosis.

Ottawa spent $58 million subsidizing the availability of healthy food through its food-mail program last year. As well, federal cash for renovating and building homes – a major health concern – has totalled about $500 million over the last three years.

Health Canada says the First Nations and Inuit portion of the Canada Prenatal Nutrition Program has an annual budget of $14 million and reaches more than 9,000 women.

Health Canada is also investing $16 million annually to help prevent fetal alcohol spectrum disorder and improve those born with it.

The federal government is by far the largest revenue source for territorial governments, which have primary responsibility for health services in the North.

Aatami said southerners wouldn’t tolerate conditions that many northerners are forced to bear.

“We’ve been telling this story over and over, over the years, but unfortunately they have been falling on deaf ears.”

Inuit infants die at well over three times the rate of other Canadian babies, according to a massive new study published Monday in the Canadian Medical Association Journal.

And as if to underscore the tough situation facing aboriginal children in Canada’s North, a second study in the same journal found that 70 per cent of Inuit preschoolers live in homes where there isn’t always enough food.

“Inuit children in Nunavut are faced with health challenges that are more severe than those in Southern Canada due to the socio-economic conditions facing the entire territory,” said Dr. Isaac Sobol, the territory’s chief public officer of health.

To study the Inuit infant mortality rate, University of Montreal researcher Dr. Zhong-Cheng Luo looked at all four million births in Canada between 1990 and 2000. He then broke out those that occurred in 53 predominantly Inuit communities in the Arctic, from Labrador in the east the Mackenzie Delta in the west.

After comparing those births with deaths in the first year of life, Luo found the mortality rate for Inuit infants was 16.5 per thousand live births – a rate not seen in Southern Canada since 1971 and 3.6 times the Canadian average of 4.6 deaths.

Luo’s data are at least a decade old, but more recent information isn’t encouraging.

“If you look at the trends over time, you do not see any improvement,” he said.

The lowest rate was in the Inuvialuit region in the Northwest Territories, at 13.4 deaths per thousand births. The highest rate was in the Nunavik region of northern Quebec, where 18.1 babies out of every thousand die before their first birthday.

The study also found a high rate of stillbirths, at 1.7 times the Canadian average.

Luo said many of the deaths are preventable.

Inuit mothers and pregnant women have high smoking and drinking rates. As well, emphasizing the importance of measures such as placing infants on their backs to sleep could reduce the incidence of Sudden Infant Death Syndrome, now seven times more common among the Inuit.

But Luo said poverty, overcrowding and generally poor living conditions in the North are likely taking their toll.

“Improving socio-economic indicators is of fundamental importance,” he said. “That’s the root cause. Infant mortality is a mirror of socio-economic conditions.”

Sobol said that there is a midwifery program in the two Nunavut regions that do not have a hospital. He said smoking and drinking among pregnant and new mothers is a problem that community nurses have been trying to deal with for a long time.

Similar issues surfaced in the second study.

Grace Egeland of McGill University surveyed 388 households in 16 Nunavut communities in 2007 and 2008. She found that 41 per cent of children between age three and five lived in homes where they either had no food for an entire day or where their parents couldn’t afford to feed them at least part of the time. Two-thirds of the parents said there were times when they ran out of food and couldn’t afford to buy more.

In all, she concluded that 70 per cent of Nunavut’s Inuit children sometimes don’t have enough to eat.

“We had an anticipation that we had a problem with the food security issue, but I didn’t realize the extent of it,” said Egeland.

Consequences range from poorer overall health to lower school achievement, she said. Paradoxically, one of those consequences is higher rates of obesity.

“It’s easier to eat a lot of high-energy, nutrient-poor foods,” said Egeland. “We find that obesity seems to track with food insecurity in developed countries.”

Egeland pointed out some households may not be spending grocery money wisely. Cigarettes are expensive, and soft drink consumption in the North is about three times Southern Canada’s rate.

Still, she said measures such as higher income support, food banks and milk programs could go a long way toward keeping young bellies full.

Sobol said food security is a complex issue in Nunavut.

“This problem is multi-faceted, involving issues such as poverty, rapid cultural change and education, and has had a profound influence on the health of Inuit in Nunavut.”

Nunavut funds a variety of food security programs, such as school breakfasts, said Sobol. Other programs such as “Drop the Pop,” which encourages people to consume fewer soft drinks, occur across the North.

“Food security is a public health issue,”said Egeland. “I’m hoping this leads to a really good assessment of health and health policy.

“Inuit are Canadians too, so let’s look after each other.”

WASHINGTON – U.S. newborns are arriving a little smaller, says puzzling new Harvard research that can’t explain why.

Fatter mothers tend to produce heavier babies, and obesity is soaring. Yet the study of nearly 37 million births shows newborns were a bit lighter in 2005 than in 1990, ending a half-century of rising birth weights. The change isn’t big: The average birth weight of full-term babies is just under 7 1/2 pounds, a drop of about 1.8 ounces, researchers reported Thursday in the journal Obstetrics & Gynecology.

That’s surprising considering doctor warnings about nine-pound, or bigger, babies. So the researchers double-checked.

The proportion born large for their gestational age dropped about two per cent, which is good.

“What physicians are responding to is that the bigger babies are getting bigger,” said lead researcher Dr. Emily Oken of Harvard Pilgrim Health Care. Plus, “babies are still bigger than they were 30, 40, 50 years ago. It’s just the trend seems to have flattened or reversed itself.”

That’s particularly true for women at lowest risk for too-small babies: White, well-educated, married non-smokers who got early prenatal care. Still, their babies, on average, weighed 2.8 ounces less over the study period.

Babies born too big are at increased risk of obesity and diabetes later in life. On the other hand, babies born too small may require intensive care right away and also be at risk for later chronic diseases. The proportion of babies small for their gestational age did increase slightly, by one per cent, Oken said.

Moreover, babies’ length at birth suggests even full-term pregnancies are 2.5 days shorter than they used to be. That can’t account for all the weight change, and Oken couldn’t find a full explanation from the birth certificates she studied.

Oken excluded premature babies, as well as twins or other multiples, from her study. (Obese mothers also are at higher risk of having a preemie.) Yes, there are more scheduled cesarean sections or induced labours now, but her analysis concluded that wasn’t to blame.

But that’s not clear as induction often isn’t listed on birth certificates, and the study found a drop in babies born at 40 or 41 weeks gestation, noted Dr. Joann Petrini, an adviser to the March of Dimes.

Regardless, it’s too soon know what this drop means for babies but “we should keep vigilant” about any decline among the smallest newborns, Petrini said.

The study uses the most recent data available from official U.S. birth certificates.

SAO PAULO, Brazil – A 2-year-old Brazilian boy stuck by his stepfather with dozens of sewing needles will be released from the hospital Friday with five needles still on his body.

Doctors were expected to remove four of the remaining needles on Monday, but decided based on new tests that they don’t need to be extracted immediately.

The Ana Neri Hospital said Tuesday in a statement that the needles may be removed in the future in minor procedures that don’t require hospitalization.

The boy underwent three surgeries after being hospitalized in December.

The toddler’s stepfather told Globo TV last year he wanted to kill the child to spite his wife. Police have formally accused him and his lover of attempted murder.

NEW YORK – U.S. health agencies said Friday research shows cause for concern over the chemical bisphenol-A’s potential effect on children when used to make baby bottles and the linings of cans of liquid infant formula, but more study is needed.

The U.S. Department of Health and Human Services said Friday they would expand efforts to research and track possible harmful effects of BPA. The chemical is used to harden plastics and has been used in water bottles, canned food lining and hundreds of other household items.

The Food and Drug Administration ruled last year trace amounts that leach out of bottles and food packaging are not dangerous. FDA officials then said they would revisit that conclusion after scientists complained it relied on a small number of industry-sponsored studies.

Some scientists believe that BPA exposure can harm the reproductive and nervous systems and possibly promote cancers. They point to findings of dozens of animal studies involving BPA, though the negative effects have not been recorded in human studies.

BPA is found in hundreds of kinds of plastic items, everything from glasses to CDs to canned food, including liquid infant formula. About 90 per cent of Americans have traces of BPA in their bodies, as the chemical leaches out of food containers.

The American Chemistry Council, an industry trade group, reiterated Friday that studies have supported the safety of BPA. The group represents BPA producers including Dow Chemical Co., Bayer AG and Hexion Specialty Chemicals.

“Extensive scientific studies have shown that BPA is quickly metabolized and excreted and does not accumulate in the body,” said an American Chemistry Council statement. “BPA is one of the most thoroughly tested chemicals in commerce today.”

Regulators, though, feel there is a need for more research.

William Corr, deputy secretary of the Department of Health and Human Services, said continued concerns over the subtle effects of BPA in laboratory animals prompted the agencies to develop a new research plan, with co-ordinated efforts from the Department of Health, the FDA, and others. The agencies will use $30 million in funding over the next 18 to 24 months to further assess the chemical in animal and human studies.

“It has not been found or proven to be harmful to children or adults,” Corr said. “But the data we’re getting deserves a much closer look.”

Meanwhile, the Department of Health recommended several steps for families concerned about BPA’s effects on infants and children, including throwing away scratched plastic baby bottles and refraining from putting hot liquids in bottles that could contain BPA.

FDA Commissioner Dr. Margaret Hamburg said that agency shares concerns over potential health issues with BPA but “needs to know more.” The agency, meanwhile, supports industry measures to stop the production of BPA-lined containers and cans.

The six major makers of baby bottles and infant feeding cups no longer use BPA in those products in the U.S., the agency said. Those products, which include Gerber and Playtex, represent more than 90 per cent of the U.S. market.

Meanwhile, the agency wants a better regulatory framework for the chemical. Currently, the chemical is in a regulation that doesn’t require industry disclosure on the amounts used in products.

Dr. Sarah Janssen, a staff scientist at the Natural Resources Defence Council, an environmental advocacy group, said the FDA already has the authority to ban certain uses of BPA, despite the agency’s claim.

“More research is always good, but we know enough now to act,” she said, calling the more aggressive stance on the chemical “too little, too late.”

“They could have made some very clear recommendations. Instead, they made some conflicting statements that didn’t give any clear advice,” she said.

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AP Business Writer Matthew Perrone contributed to this report from Washington.

HANOI, Vietnam – Nearly half of all births in China are delivered by caesarean section, the world’s highest rate, according to a survey by the World Health Organization – a shift toward modernization that isn’t necessarily a good thing.

The boom in unnecessary surgeries is jeopardizing women’s health, the U.N. health agency warned in the report published online Tuesday in the medical journal The Lancet.

Unnecessary C-sections are costlier than natural births and raise the risk of complications for the mother, said the report surveying nine Asian nations. It noted C-sections have reached “epidemic proportions” in many countries worldwide.

The most dramatic findings were in China, where 46 per cent of births reviewed were C-sections – a quarter of them not medically necessary, the report said.

“So many pregnant women ask for a caesarean birth in China, but we always suggest that they have a natural birth,” said Dr. He Yuanhua, at Capital Antai Obstetrics and Gynecology Hospital in Beijing, who did not participate in the study.

“It’s bad to have so many caesarean births because natural birth is the ideal way.”

The WHO, which reviewed nearly 110,000 births across Asia in 2007-2008, found 27 per cent were done under the knife, partially motivated by hospitals eager to make more money.

That mirrors similar results reported by WHO in 2005 from Latin America, where 35 per cent of pregnant women surveyed were delivering by C-section.

In June 2008, Canada’s Society of Obstetricians and Gynaecologists said 26.3 per cent of women giving birth did so by C-section, a dramatic rise from 17 per cent of births in 1993.

In the U.S., where C-sections are at an all-time high of 31 per cent, the surgery is often performed on older expectant mothers, during multiple births or simply because patients request it or doctors fear malpractice lawsuits. A government panel warned against elective C-sections in 2006.

“The relative safety of the operation leads people to think it’s as safe as vaginal birth,” said Dr. A. Metin Gulmezoglu, who co-authored the Asia report. “That’s unlikely to be the case.”

Women undergoing C-sections that are not medically necessary are more likely to die or be admitted into intensive care units, require blood transfusions or encounter complications that lead to hysterectomies, the WHO study found.

U.S. studies have shown babies born by caesarean have a greater chance for respiratory problems. The Asia survey found the procedure benefits babies during breech births.

Reasons for elective C-sections vary globally, but increasing rates in many developing countries coincide with a rise in patients’ wealth and improved medical facilities.

In Asia, some women opt for the surgery to choose their delivery day after consulting fortune tellers for “lucky” birthdays or times. Others fear painful natural births or worry their vaginas may be stretched or damaged by a normal delivery. Some women also prefer the operation because they mistakenly believe it is less risky.

“I think it’s safer for the mother and child to have C-sections, and the relatives feel more secure because it’s very simple and very common now,” said a Vietnamese woman, Trang Thanh Van, 25, just days away from giving birth to her first child. “People worry that using tools to pull the baby out (in a vaginal birth) may affect their brains.”

The Asian survey examined deliveries in 122 randomly selected public and private hospitals in 2007 and 2008 across Cambodia, China, India, Japan, Nepal, the Philippines, Sri Lanka, Thailand and Vietnam. The hospitals were located in capital cities and two other regions or provinces within each country, all logging more than 1,000 births a year.

China’s 46 per cent C-section rate was followed by Vietnam and Thailand with 36 per cent and 34 per cent, respectively. The lowest rates were in Cambodia, with 15 per cent, and India, with 18 per cent.

The study did not discuss specific reasons for the high number of C-sections, but it noted that more than 60 per cent of the hospitals studied were motivated by financial incentives to perform surgeries.

At Vietnam’s National Hospital of Gynecology and Obstetrics in Hanoi, about 40 per cent of the 20,000 babies delivered there annually are by C-section, said Dr. Le Anh Tuan, the hospital’s vice director, who did not participate in the study.

As the capital’s largest maternity hospital, it receives the most complicated cases, with many women undergoing emergency surgery. But he said another reason is women with small frames whose babies are simply too large for them to deliver naturally.

“The babies are bigger, even than in Western countries,” he said. “Vietnam was a country where we didn’t have enough food to eat. Now we have a surplus of food. The women think that if they eat a lot, their babies will be healthy.”

In Latin America, C-section rates in all eight countries surveyed earlier by WHO were 30 per cent or higher – similar to the U.S. rate. In Paraguay, 42 per cent of deliveries were by caesarean, and in Ecuador 40 per cent.

Some expectant mothers in Latin America scheduled elective surgeries to avoid giving birth during holidays or even so they could attend parties, said Dr. Archana Shah, from the WHO in Geneva, who worked on that report and cautioned that data in both studies represent a sample that may not reflect overall national rates.

That compares to an earlier WHO survey of African countries, where C-sections were performed in only about nine per cent of deliveries surveyed and where many medical centres were ill-equipped to perform emergency surgeries, leading to increased deaths.

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Associated Press researcher Yu Bing in Beijing contributed to this report.

With files from The Canadian Press