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Purpose: The objective of this study was to analyze the birth methods (vaginal, with medical intervention, or by Cesarean Section, CS) predominant in the Malopolska province, to describe the risk factors for non-physiologically normal births, and to characterize the demographics of women who give birth and selected parameters of maternity care. Methods: The retrospective analysis was conducted on data collected in 2013–2014 in the framework of the current activity of the Polish National Health Fund and encompassed 68,894 childbirths from 29 hospitals in 21 towns in the south of Poland. Results: In the study period, 38,366 (56.5%) of the births in Malopolska were vaginal, and only 22,839 (22.9%) of births were considered ‘normal’, without an episiotomy. The remaining were births by CS (29,551; 43.5%). Factors increasing the chances of having a normal childbirth in comparison with birth by CS were as follows: days free from work, living in a village, woman’s age > 35 years, and the hospital’s referral level (primary or secondary). Women aged 18–34 years and those living in a village/town were more frequently admitted directly into the birth room without a stay in the maternity units. There was a high level of medicalization of births in Malopolska: natural labour and childbirth were rare. It seems that efforts to increase natural birth rates should be directed toward both reducing the CS rate as well as increasing vaginal birth without an episiotomy.

Background The article analyzes hospitalizations of women in the postpartum period in the Małopolska Province. Re-hospitalization of women as a result of puerperal complications may be used as an infection control quality measure in this patient population. Methods It was a population-based, retrospective analysis using data obtained from the Polish National Health Fund (paying for medical services, financed by all Polish employees contributing 9% of their salaries), collected routinely in 2013–14. The analysis encompassed 29 hospitals and 68 894 childbirths. Results In total, 1.7% of women were re-hospitalized and 563 of these re-hospitalizations (0.8%) were due to infection. Re-hospitalizations due to infections were significantly more often recorded among women who lived in villages compared with inhabitants of towns (OR 1.6, 95% CI 1.23–1.98; P < 0.001) and in women giving birth in primary referral hospitals in comparison with the second referral or clinical hospitals (OR 2.8, 95% CI 1.69–4.65; P < 0.001). On the one hand, the results of the study indicate that, in patients giving birth, the infection control system is not sensitive enough, and on the other hand, more detailed studies need to cover primary referral hospitals, specifically. Conclusions The problem of the infection-associated hospitalizations in the postpartum period is not reliably assessed by infection control professionals and constitutes a challenge for surveillance, including prevention and control. Complications associated with childbirth should be an indication of the quality of healthcare provision and knowledge of the scale of the problem should be the basis for its evaluation and prevention. This is especially true for infections in puerperas.

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