Rising caesarean section rates: a cause for concern?

Matthews, Tom; Crowley, Patricia; Chong, A.; McKenna, Peter; McGarvey, Cliona; O’Regan, Myra

doi:10.1046/j.1471-0528.2003.02010.x

Cited by 54 publications

(15 citation statements)

References 6 publications

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“…Our results show that although the model of obstetrician‐led care is characterised by increased rates of intervention, outcomes for women with a single baby delivered at term are no worse, and further studies may determine there are benefits for women and their babies. This is consistent with findings from both the United Kingdom 26 and developing countries 27 that increases in the rate of caesarean section are associated with a reduction in the rate of perinatal mortality.…”

Section: Discussionsupporting

confidence: 91%

Adverse outcomes of labour in public and private hospitals in Australia: a population‐based descriptive study

Robson

Laws

Sullivan

2009

Medical Journal of Australia

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Objective: Design, setting and participants: A population‐based study of 789 240 term singleton births in public and private hospitals in 2001–2004, using data from the National Perinatal Data Collection. Main outcome measures: Third‐ and fourth‐degree perineal injury, requirement for high level of neonatal resuscitation, Apgar score < 7 at 5 minutes, admission to neonatal intensive care unit or special care nursery, and perinatal death. Results: 31.4% of the term singleton births occurred in private hospitals. After adjusting for maternal age, Indigenous status, parity, smoking status, diabetes, hypertension, remoteness of usual residence, and method of birth, the rates of all adverse outcomes studied were higher for public hospital births. For women, the adjusted odds ratio (AOR) for third‐ or fourth‐degree perineal injury was 2.28 (95% CI, 2.16–2.40). For babies, the odds of a high level of resuscitation (AOR, 2.37; 95% CI, 2.17–2.59), low Apgar score (AOR, 1.75; 95% CI, 1.65–1.84), intensive care requirement (AOR, 1.48; 95% CI, 1.45–1.51) and perinatal death (AOR, 2.02; 95% CI, 1.78–2.29) were all higher in public hospitals. Conclusion: For women delivering a single baby at term in Australia, the prevalence of adverse perinatal outcomes is higher in public hospitals than in private hospitals.

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Section: Discussionsupporting

confidence: 91%

Adverse outcomes of labour in public and private hospitals in Australia: a population‐based descriptive study

Robson

Laws

Sullivan

2009

Medical Journal of Australia

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“…It is of particular importance to study the CSD at this time because of its rising rates in Mexico, Canada, and some European, Asian, and South American countries such as Brazil, where the rate in public hospitals is as high as 80% (Kambo, Bedi, Dhillon, & Saxena, 2002; Lin & Xirasagar, 2004; Matthews et al, 2003; Trujillo‐Hernandez et al, 2002). Increases in CSD rates may be attributed to a range of factors, including obstetric practice, litigation issues, financial incentives, and shifting trends among women giving birth such as advancing age and excessive pregnancy weight gain (Luthy, Malmgren, Zingheim, & Leininger, 2003; Rosenberg, Garbers, Lipkind, & Chiasson, 2005; Villar et al, 2006; Xirasagar, Lin, & Liu, 2006), as well as issues of choice (Declercq, Menacker, & Macdorman, 2006).…”

Section: Discussionmentioning

confidence: 99%

Maternal brain response to own baby‐cry is affected by cesarean section delivery

Swain¹,

Tasgin

Mayes

et al. 2008

Child Psychology Psychiatry

192

154

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A range of early circumstances surrounding the birth of a child affects peripartum hormones, parental behavior and infant wellbeing. One of these factors, which may lead to postpartum depression, is the mode of delivery: vaginal delivery (VD) or cesarean section delivery (CSD). To test the hypothesis that CSD mothers would be less responsive to own baby-cry stimuli than VD mothers in the immediate postpartum period, we conducted functional magnetic resonance imaging, 2–4 weeks after delivery, of the brains of six mothers who delivered vaginally and six who had an elective CSD. VD mothers’ brains were significantly more responsive than CSD mothers’ brains to their own baby-cry in the superior and middle temporal gyri, superior frontal gyrus, medial fusiform gyrus, superior parietal lobe, as well as regions of the caudate, thalamus, hypothalamus, amygdala and pons. Also, within preferentially active regions of VD brains, there were correlations across all 12 mothers with out-of-magnet variables. These include correlations between own baby-cry responses in the left and right lenticular nuclei and parental preoccupations (r = .64, p < .05 and .67, p < .05 respectively), as well as in the superior frontal cortex and Beck depression inventory (r = .78, p < .01). First this suggests that VD mothers are more sensitive to own baby-cry than CSD mothers in the early postpartum in sensory processing, empathy, arousal, motivation, reward and habit-regulation circuits. Second, independent of mode of delivery, parental worries and mood are related to specific brain activations in response to own baby-cry.

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“…A recent analysis of over 420 000 births at three busy maternity hospitals in Dublin found that “an increasing caesarean section rate was strongly associated with a lower mortality rate in normally formed babies of normal birthweight (greater than 2500 g)”. These findings have been confirmed in studies of other large hospitals in the United Kingdom 15 . This conclusion directly contradicts the orthodoxy that caesarean section rates above 10%–15% impart no additional health benefits 16…”

mentioning

confidence: 82%

Throwing out the baby with the spa water?

Costa

Robson

2004

Medical Journal of Australia

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Australia is now one of the safest countries in the world in which to be born. This is largely a result of the many advances in obstetric and neonatal medicine of the past 50 years. However, the “medicalisation” of birth has tended to diminish women's satisfaction with their experience of childbirth. It has been shown that women are most satisfied by care from a single practitioner, and when they themselves have input into decision‐making. Although maternal satisfaction is important, it should not be promoted at the expense of the health of mothers and babies. More realistic antenatal education and preparation should be available for all pregnant women so that both maternal satisfaction and good perinatal outcomes can be achieved.

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Rising caesarean section rates: a cause for concern?

Cited by 54 publications

References 6 publications

Adverse outcomes of labour in public and private hospitals in Australia: a population‐based descriptive study

Adverse outcomes of labour in public and private hospitals in Australia: a population‐based descriptive study

Maternal brain response to own baby‐cry is affected by cesarean section delivery

Throwing out the baby with the spa water?

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