Prepartum and intrapartum caesarean section rates at Mater Mothers’ Hospital Brisbane 1997–2005

Abstract

The increase in prepartum and intrapartum caesarean section displayed was not fully explained by medical and demographic changes in the population.

Breastfeeding after cesarean delivery: a systematic review and meta-analysis of world literature

“…The contribution of maternal choice to the increasing elective CD rate is important. In the United Kingdom, 6-8% of pregnant women express a preference for CD (18), whereas in Australia, an increase in elective CD has not been accompanied by increases in potentially explanatory healthrelated factors (159). However, maternal choice is not the only reason for elective CD, and there are a wide range of medical reasons that obstetricians recommend a prelabor CD (160).…”

Going public: Do risk and choice explain differences in caesarean birth rates between public and private places of birth in Australia?

“…In recent decades, a decision was made by the Australian Government to offer subsidised private health insurance premiums in order to increase uptake of private health insurance earlier in life. As a result, the proportion of women in Australia birthing as a private patient increased (Shorten and Shorten, 2004;Janssens et al, 2008). Currently, around one third of women in Australia choose private maternity care, with the remainder accessing one of a number of different models of publically-funded maternity care (Laws et al, 2010).…”

“…The second is that differences between the sub-populations accessing each sector in preferences, or the ability to exercise preferences, accounts for differences in caesarean section rates (e.g., Papapetros, 2001). The third is that differences in rates of caesarean section may be attributable to sector differences in how care is organised and delivered (Roberts et al, 2000;Shorten and Shorten, 2004;Shorten and Shorten, 2007;Janssens et al, 2008).…”

“…Furthermore, there is a higher incidence of caesarean birth in private models of care for women within many different categories of specific types of risk (e.g., abnormal fetal presentation, plurality, parity, uterine scar, gestational age and induction of labour; Howell et al, 2009). Janssens et al (2008) reviewed the caesarean birth rates in a major metropolitan hospital servicing both public and private patients in Queensland, Australia between 1997 and 2005. They found that the overall rate of caesarean birth increased by an average of 2% every year, and while there were no sector differences in the rate of increase of intrapartum caesarean birth, caesarean birth prior to the onset of labour increased at double the rate for women in the private sector.…”

Would it be too late? A retrospective case–control analysis to evaluate maternal–fetal outcomes in advanced maternal age

“…Despite the substantial improvement of obstetric diagnostic and therapeutic methods, accumulating evidence suggests that advanced maternal age (AMA) is still associated with adverse outcomes of pregnancy, including high percentage of spontaneous abortion (SA) and gestational hypertension (GH) [1][2][3], intrauterine growth restriction, neonatal low-birth weight (LBW; \2,500 g) and small fetus for the gestational age (SGA; \10th %) [4,5], preterm delivery (PTD; \37 weeks) [6], twin pregnancies [particularly after assisted reproductive technologies (ART)] [1][2][3], endouterine fetal death [7,8], chromosomal aberrations [9][10][11], need of cesarean section [12][13][14]. In particular, risks associated with delayed childbearing become significant for maternal age greater than 35 years [15,16].…”