Cesarean sections in Brazil’s teaching hospitals: an analysis using Robson Classification

Abstract

Objective. To determine the distribution of cesarean sections performed in teaching hospitals participating in the Project for Improvement and Innovation in the Care and Teaching of Obstetrics and Neonatology (Apice ON) using the Robson Classification. Methods. Cross-sectional descriptive study on cesarean sections performed at Apice ON hospitals according to the Robson Classification, using secondary data from the 2017 Live Births Information System on the year prior to project implementation, hence a baseline study. Hospitals are described according to their geographic distribution and cesarean section rates, using absolute and relative frequencies. Results. The proportions of newborns by Robson groups were similar to those proposed by the World Health Organization, except for Group 5 (with previous cesarean section) and Group 10 (preterm), with regional differences. The teaching hospitals’ average cesarean section rates ranged from 24.8% to 75.1%, exceeding by far the recommended values, even in Robson groups considered low risk for cesarean section (Groups 1 to 4). Conclusions. Brazilian teaching hospitals displayed cesarean section rates higher than those recommended by the World Health Organization for all groups; a worrisome fact, as by teaching they induce attitudes in future professional practices. These results highlight the importance of a reliable information system. Monitoring and evaluation of cesarean sections using the Robson Classification can be an important tool to guide management and propose actions to reduce rates. Countries with high cesarean section rates might explore this hypothesis in their teaching hospitals in order to define policies for the reduction of their rates.

Desired versus actual delivery route: nursing students’ perception about their type of delivery

“…Agreeing with what was exposed in this study, regarding the prominence of C-sections as a procedure performed, a Brazilian cross-sectional study reports that in the face of admissions of pregnant women for childbirth care, the mean rates of C-sections in the units surveyed ranged from 24.8% to 75.1%, drastically exceeding the 15% recommended by the World Health Organization (WHO), potentially leading to consequences of potential risk to mother and child (18,19) .…”

Analysis of Cesarean Section Rates in a Public Tertiary Hospital During Teaching and Non-teaching Periods Using the Robson Ten Group Classification System

“…The large number of primary CS in Groups 1 and 2 becomes even more significant to the future overall CS rate. As a result, efforts to halt the rising trend of CS rates must address these groups to be successful [ 10 ]. The detailed indications of CS among primiparous women (Groups 1 and 2) may aid in our understanding of the situation.…”

Parto almejado versus realizado: percepção de acadêmicas de enfermagem acerca do seu tipo de parto

“…Concordando com o exposto neste estudo, em relação ao destaque de operações cesarianas como procedimento realizado, um estudo transversal brasileiro refere que diante das internações das gestantes para assistência ao parto, as taxas médias de cesariana das unidades pesquisadas variaram entre 24,8% a 75,1%, superando drasticamente os 15% recomendados pela Organização Mundial da Saúde (OMS), podendo acarretar consequências de risco potencial à mãe e ao filho (18,19) .…”