Prenatal care and socioeconomic status: effect on cesarean delivery

Abstract

Cesarean deliveries are widely used in many high- and middle-income countries. This overuse both increases costs and lowers quality of care and is thus a major concern in the healthcare industry. The study first examines the impact of prenatal care utilization on cesarean delivery rates. It then determines whether socioeconomic status affects the use of prenatal care and thereby influences the cesarean delivery decision. Using exclusive French delivery data over the 2008–2014 period, with multilevel logit models, and controlling for relevant patient and hospital characteristics, we show that women who do not participate in prenatal education have an increased probability of a cesarean delivery compared to those who do. The study further indicates that attendance at prenatal education varies according to socioeconomic status. Low socioeconomic women are more likely to have cesarean deliveries and less likely to participate in prenatal education. This result emphasizes the importance of focusing on pregnancy health education, particularly for low-income women, as a potential way to limit unnecessary cesarean deliveries. Future studies would ideally investigate the effect of interventions promoting such as care participation on cesarean delivery rates.

Cesarean delivery rate and staffing levels of the maternity unit

“…Because clinical indications are unlikely to explain more than a portion of all cesarean deliveries [22, 23], the involvement of nonclinical factors should also be studied. Individual preferences and characteristics of women affect cesarean use [24–26], as do physicians’ attitudes and incentives [27–29]. Factors related to the maternity unit are also important.…”

The effect of anaesthesia and antenatal care on feto-maternal outcome after caesarean section in a developing country

“…6,7 Caesarean deliveries are currently one of the most common surgical procedures in the world. 8 The CS rate recorded in this study is very high when compared to the world health organization (WHO) recommended rate of between 10 and 15% of total deliveries, regardless of the region or the country. 9 The commonest indication for caesarean section in this study is obstructed labour.…”

Framing the discussion of microorganisms as a facet of social equity in human health

“…The perinatal time period, because of maternal microbial transfer, is a clear early intervention target for public health and social equity [2,19,20] and societal economic outcomes [21]. Adequate perinatal education and healthcare are well demonstrated to reduce antenatal healthcare costs [22,23], improve maternal and offspring health and psychological well-being over their lifetimes [21,24], and improve breastfeeding rates [23,25]. However, women who are socioeconomically disadvantaged experience social barriers and stressors preventing access to prenatal care, adequate nutrition, or education [23,26].…”

“…Adequate perinatal education and healthcare are well demonstrated to reduce antenatal healthcare costs [22,23], improve maternal and offspring health and psychological well-being over their lifetimes [21,24], and improve breastfeeding rates [23,25]. However, women who are socioeconomically disadvantaged experience social barriers and stressors preventing access to prenatal care, adequate nutrition, or education [23,26]. This increases the risk for complications during and after birth and increases psychological stressors, which further worsen health outcomes [13].…”