Exploring factors influencing Chinese women's decision to have elective caesarean surgery

Lee, Linda Yin King; Holroyd, Eleanor; Ng, Chun Y.

doi:10.1054/midw.2001.0274

Cited by 51 publications

(59 citation statements)

References 22 publications

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“…A atenção à gestante abre espaço para a formação de opinião entre as mulheres, o que, por sua vez, poderá influenciar a decisão final sobre o tipo de parto 1,13,21,37,38,39 . O esclarecimento sobre vantagens e desvantagens de todas as práticas existentes para o atendimento ao parto, principalmente para as mães de primeiro filho, pode diminuir o medo do parto vaginal, aumentar o entendimento dos riscos de uma cirurgia sem indicações mé-dicas e, conseqüentemente, diminuir as cesarianas repetidas nesse grupo de mulheres 4,16,18,30 .…”

Section: Discussionunclassified

Fatores associados à cesariana entre mulheres de baixa renda em Pelotas, Rio Grande do Sul, Brasil

Silveira

Santos

2004

Cad. Saúde Pública

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Section: Discussionunclassified

Fatores associados à cesariana entre mulheres de baixa renda em Pelotas, Rio Grande do Sul, Brasil

Silveira

Santos

2004

Cad. Saúde Pública

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“…However, there is no previous literature on the difference in the CCS and NCS performed between primiparas and multiparas as far as we could ascertain from our data search, and therefore we herein report this difference for the first time. Increased maternal age and higher maternal weight gain are more frequently associated with difficult labor, such as inadequate uterine contraction and prolonged labor (Lee et al 2001). So those women will also choose NCS rather than VD based on consideration for the safety of delivery.…”

Section: Factors Relating To the Choice Of Ncsmentioning

confidence: 99%

Factors Related to the High Cesarean Section Rate and Their Effects on the "Price Transparency Policy" in Beijing, China

Hong

2007

Tohoku J. Exp. Med.

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In urban China, many non-clinically indicated cesarean sections (NCSs) are performed, resulting in an unnaturally high cesarean section (CS) rate. NCSs represent CSs without any specific medical indications. The demand for NCS may be due to women's preference for CS and their belief in its safety and comfortableness. In addition, CS is more profitable for the supply side than vaginal delivery, which results in a continued rise in delivery expenditures. As a result, the so-called "price transparency policy", which forces hospitals to declare their average hospital charges, was adopted to control the delivery expenditures in the ongoing Chinese healthcare reform policy. The purpose of this study is to prove that the supply and demand factors affect the choice of delivery modes and more resources are consumed in NCS. The data of 680 live deliveries were collected from three hospitals in Beijing. Multinomial logistic regression analyses were conducted to identify the factors related to choosing NCS, and ANOVA and ANCOVA were used to compare the charges, proxy for resource utilization, among the delivery modes or hospitals. The results showed that the high NCS rate (37.7%) might be predicted not only based on the demand factors (region of residence, parity, maternal age and weight gain) but also on the supply factors (hospital dummy, revenue-staff ratio, bed turnover rate and obstetric medical staffs-delivery ratio), suggesting that such induced NCSs result in an unnecessarily high resource consumption. These data suggest that the present Chinese policy fails to control delivery expenditures.China; choice of delivery modes; hospital charge; non-clinically indicated caesarean section (NCS); price transparency policy

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“…13 Many Chinese couples now delay childbearing, aim to have not more than one birth experience and opt for delivery by caesarean section to avoid pain. 13,14 Data from hospital-based studies in urban China showed rates of caesarean section of between 26% and 63% during the late 1990s. [15][16][17][18] Another population-based study reported a substantial increase during the last three decades, from 4.7% to 22.5%.…”

Section: Introductionmentioning

confidence: 99%

Delivery settings and caesarean section rates in China

Sufang¹,

Padmadas

Zhao

et al. 2007

Bull World Health Organ

114

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Objective To quantify the influence of increasing use of health-care services on rising rates of caesarean section in China. Methods We used data from a population-based survey conducted by the United Nations Population Fund during September 2003 in 30 selected counties in three regions of China. The study sample (derived from birth history schedule) consisted of 3803 births to mothers aged less than 40 years between 1993 and 2002. Multiple logistic regression models were used to estimate the effect of health-care factors on the odds of a caesarean section, controlling for time and selected variables. Findings Institutional births increased from 53.5% in 1993-1994 to 82.2% in 2001-2002, while the corresponding increase in births by caesarean section was from 8.9% to 24.8%, respectively. Decomposition analysis showed that 69% of the increase in rates of caesarean section was driven by the increase in births within institutions. The adjusted odds of a caesarean section were 4.6 times (95% confidence interval, CI: 3.4-11.8) higher for recent births. The adjusted odds were also significantly higher for mothers who had at least one antenatal ultrasound test. Rates of caesarean section in secondary-level facilities markedly increased over the last decade to the same levels as in major hospitals (P < 0.001). Conclusion The upsurge in rates of births by caesarean section in this population cannot be fully explained by increases in institutional births alone, but is likely to be driven by medical practice within secondary-level hospitals and women's demand for the procedure. Une traduction en français de ce résumé figure à la fin de l´article. Al final del artículo se facilita una traducción al español.

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Exploring factors influencing Chinese women's decision to have elective caesarean surgery

Cited by 51 publications

References 22 publications

Fatores associados à cesariana entre mulheres de baixa renda em Pelotas, Rio Grande do Sul, Brasil

Fatores associados à cesariana entre mulheres de baixa renda em Pelotas, Rio Grande do Sul, Brasil

Factors Related to the High Cesarean Section Rate and Their Effects on the "Price Transparency Policy" in Beijing, China

Delivery settings and caesarean section rates in China

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