Factors associated with high Cesarean deliveries in China and Brazil - A Call for reducing elective surgeries in moving towards Universal Health Coverage

Hou, Xiaohui; Rakhshani, Noor Sabah; Iunes, Roberto F.

doi:10.5430/jha.v3n5p67

Cited by 10 publications

(10 citation statements)

References 49 publications

(63 reference statements)

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“…Our study found that education is signi cantly associated with an increased likelihood of cesarean delivery at the national level. This nding is consistent with several previous studies conducted in Bangladesh, 23,24 Brazil, 25 Pakistan, 7 Nepal 3 and China 26 . Women with higher education may have better decision-making ability to access obstetric care and more aware of the risk of childbirth-related complications.…”

Section: Discussionsupporting

confidence: 93%

“…A study conducted in Madhya Pradesh reported that about 41% of maternal death occurred among tribal women. 28 Several studies from Bangladesh, 6 Pakistan, 7 China, 26 Mozambique 29 and Ghana 30 demonstrated a signi cant in uence of wealth status on cesarean delivery. In this study, the rate of cesarean delivery increased from bottom to upper wealth index groups.…”

Section: Discussionmentioning

confidence: 99%

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Assessing Socio-Demographic Factors of Cesarean Delivery in India: Insights From National Family Health Survey-4

Roy

Paul

Saha

et al. 2020

Preprint

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Background: The rate of cesarean delivery has considerably increased in the world during the last few decades. This paper aims to investigate the prevalence and socio-demographic correlates of cesarean delivery in India with a focus on Bihar and Tamil Nadu, accounting for the lower and higher proportion of cesarean birth.Methods: The study is based on secondary data, collected from the latest National Family Health Survey in 2015-16 (NFHS-4). The present study is based on 190,898 most recent births during the five years preceding the survey. Bivariate and multivariate analyses were carried out to identify the factors associated with cesarean delivery.Results: The highest rate of cesarean delivery was observed in Telengana (60%) and followed by Andhra Pradesh (42%), Tamil Nadu (36%). C-section found to be negligible in low-income states, namely Bihar (7%), Madhya Pradesh (10%) and Jharkhand (11%). Multivariate analysis revealed that the prevalence of cesarean delivery was substantially higher among women who married at higher age, with first birth-order, women in the ‘obese’ category with higher education, those from upper quintile of household wealth. Similarly the incidence of cesarean birth was remarkably higher in private hospitals both in the Indian sample (OR 3.9, 95% CI: 3.77-4.03) and in the selected states, Bihar (12.86, 95% CI: 10.92-15.15) and Tamil Nadu (OR 2.74, 95% CI: 2.40-3.13), compared to the public hospitals. Conclusion: Our study revealed that there are a high proportion of women delivering babies through cesarean section in South India. Thus, medical justifications need to be taken to deal with this concern. On the other hand, Women should also be driven towards regular ANC check-ups for the well-being of maternal and newborn health that can also help to increase the cesarean delivery for women who need C-section delivery especially in low-income states.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Assessing Socio-Demographic Factors of Cesarean Delivery in India: Insights From National Family Health Survey-4

Roy

Paul

Saha

et al. 2020

Preprint

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“…In the United Kingdom (UK) for example, the rate of birth by CS was 23 % in 2007 (Declercq et al 2010), almost twice the estimated 12.5 % reported in 1990 (Black et al 2005). Increasing rate of birth by CS is even higher elsewhere, such as China and Brazil (Hou et al 2014). Similarly, induction of labor (IOL) is becoming more common (Knight et al 2013) and in 2011, it was estimated that 25 % of all births in developed countries were induced (World Health Organization 2011).…”

Section: Introductionmentioning

confidence: 98%

Obstetrical Mode of Delivery and Childhood Behavior and Psychological Development in a British Cohort

Curran

Cryan

Kenny

et al. 2015

J Autism Dev Disord

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The association between mode of delivery [specifically birth by Cesarean section (CS)] and induction of labor (IOL) psychological development at age 7 was assessed [including autism spectrum disorders (ASD), attention-deficit/hyperactivity disorder (ADHD) and behavioral difficulties]. The Millennium cohort study, a nationally representative UK cohort of children (including 13,141 children), was used. There was no association between planned CS and ASD [aOR 0.58; (95 % CI 0.19-1.79)] or ADHD [aOR 0.54; (95 % CI 0.18-1.64)] analyses. Induced vaginal delivery was significantly associated with behavioral difficulties in unadjusted [OR 1.26; (95 % CI 1.03-1.54)], but not adjusted analysis [OR 1.15; (95 % CI 0.82-1.60)]. There was no association between mode of delivery and ASD or ADHD in this cohort. Further research is needed to understand the relationship between mode of delivery and IOL and psychological development.

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“…Research on the high numbers of surgical deliveries in private hospitals indicates that the economic dimension has an important role in the commitment of doctors to carrying out surgical-cesarean births (Hopkins, 2000;Poterr et al, 2003;Haddad and Cecatti, 2011;Hopkins et al, 2014;Hou et al, 2014). In public services and the supplementary network (health insurance), the values paid to obstetricians for assistance during vaginal births and surgical-cesarean births is the same, but in private practice there is no rule, and each obstetrician negotiates their fee with the women.…”

Section: Discussionmentioning

confidence: 99%

The Language of Risk, Public Policies, and Childbirth in the Municipality of São Paulo: A Reading of Data From the Live Birth System 2010–2016

2018

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The main factor for the hospitalization of childbirth was the expansion of power-knowledge in eighteenth century medicine. In Brazil, throughout the twentieth century, public policies for women's health focused care on biological and reproductive dimensions, and birth control technologies. Technoscience advances in producing knowledge and interventions regarding women's bodies led to a medicalization of labor and birth, consolidating the hospital as an ideal space. This article aims to examine numbers of surgical-cesarean births in the municipality of São Paulo, and to discuss how racial, cultural, social, and economic inequalities influence forms of birth. The statistics have been problematized in their connections with the language of risk, actors, and materialities involved in producing surgical births: public policies for pregnancy, labor, and post-natal care, hospitals. Research was carried out in the repository of public data on births in the municipality of São Paulo, in the period between 2010 and 2016, focusing on types of birth, in relation to place of birth, and women's race/color and levels of education. The analysis indicated that the majority of births are surgical-cesarean, at a number five times higher than that recommended by the World Health Organization; the number is even higher at private hospitals and among women who declared themselves as white or asian. Higher levels of education are also linked to this elevated number of births. Vaginal birth numbers were greater in public hospitals for women who declared themselves as black, mixed race, and native Brazilian. The language of risk guides public policies, delivery practices, and childbirth in Brazil. The lack of investment in birth centers in the country encourages hospitalization. Health professionals attending births have a central role in maintaining the culture of surgical delivery. Surgical-cesarean birth as a woman's choice is an argument based on childbirth myths, on incorrect information about physiological and psychological processes, and lack of support from health professionals and families faced with the desire for vaginal birth. The complexity of the situation demands recognition that these realities are built on several factors, interconnected in the day-to-day of health services.

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Factors associated with high Cesarean deliveries in China and Brazil - A Call for reducing elective surgeries in moving towards Universal Health Coverage

Cited by 10 publications

References 49 publications

Assessing Socio-Demographic Factors of Cesarean Delivery in India: Insights From National Family Health Survey-4

Assessing Socio-Demographic Factors of Cesarean Delivery in India: Insights From National Family Health Survey-4

Obstetrical Mode of Delivery and Childhood Behavior and Psychological Development in a British Cohort

The Language of Risk, Public Policies, and Childbirth in the Municipality of São Paulo: A Reading of Data From the Live Birth System 2010–2016

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