Urban hospital cesarean section delivery rates in Paraíba State, Brazil, 1977-81.

Abstract

Parafba State, Brazil is one of the poorest areas in that country; many of the hospitals are not high quality and medical training is not comparable to that of developed countries. Nevertheless, the rate of cesarean section delivery in urban hospitals has risen from 19.0 per cent in 1977 to 28.5 in 1981. Despite the larger volume of obstetric services in government hospitals, these hospitals had lower cesarean section rates than private hospitals, both profit and non-profit. (Am J Public Health 1988; 78:704-705.)

Rising rates, changing relationships: caesarean section and its correlates in South Korea, 1988–2000

“…Wagner 45 argued that caesarean rates are higher when maternity care is characterised by medical hegemony and midwives are marginalised. It has been widely reported that caesarean rates of private health institutions are greater than those of public one 8,16,17,22,25,28–30 . In addition, a Chilean study found that a drive toward the privatisation of health care may have had deleterious effects on the caesarean rates 46 .…”

“…Other studies found a negative or no relationship between caesarean section and education 27,29 or income 21,27 . In addition, private health institutions reportedly had higher caesarean rates than public ones 8,16,17,22,25,28–30 . However, with the exception of some reports, 26,29 research regarding trends in the relationship between mode of delivery and its correlates has been scarce.…”

“…Although it is clear that South Korea went through a dramatic upsurge in caesarean rates, the factors that are related with caesarean section in South Korea are not well known. Many studies have explored factors regarding women and/or healthcare providers and the relationship to caesarean rates 8,16–30 . Some studies found a positive association between caesarean rates and socio‐economic position as measured by education, 16,24,25,28,30 income 18,19,23,26 and occupational class 20,28 .…”

Factors affecting choice of sterilisation among low income women in Paraíba, Brazil

“…Whether or not this can be explained by medical considerations is not clear. Because caesarean section in Brazil in general and Paraiba in particular is very high (Rodrigues, 1988;Barros, Vaughan & Victora, 1986) women with a third or fourth caesarean section will often be sterilised for medical reasons.…”

Hospital utilization and reimbursement method in Brazil

“…The number of patients under obstetric treatment in private hospitals may have decreased, but length of stay may have increased taking into consideration that the Caesarian section rate has been increasing over the year. It has been claimed that Brazil has the highest Caesarian section rate in the world: financial incentives seem to be influencing this medical procedure (Rodrigues, 1988; Barros et al, 1986;Lins and Fortney, 1981). Table 4 shows the variations in inpatient care from 1980 to 1986 across the three most populated regions in Brazil, which have accounted for approximately 90 percent of all hospitalizations.…”