The Costs and Their Determinant of Cesarean Section and Vaginal Delivery: An Exploratory Study in Chongqing Municipality, China

Abstract

Objectives. This study aims to analyze the cesarean section (CS) rates and vaginal delivery rates in tertiary hospitals of China, explore the costs of two different deliveries, and examine the relative influencing factors of the costs in both CS and vaginal deliveries. Methods. 30,168 anonymized obstetric medical cases were selected from three sample tertiary hospitals in Chongqing Municipality from 2011 to 2013. Chi-square test was used to compare the distributions of CS and vaginal deliveries under different indicators. Mann–Whitney test and Kruskal-Wallis test were adopted to analyze the differences under different items. Multiple linear regression was used to determine the influencing factors of the costs of different delivery modes. Results. (1) The rates of CS were 69%, 65.5%, and 59.2% in the three sample tertiary hospitals in Chongqing from 2011 to 2013. (2) The costs and the length of stay of CS were greater than those of vaginal delivery, which had significant differences (P < 0.005). (3) The areas, length of stay, age, medical insurance, and modes of delivery were the influencing factors of both CS and vaginal delivery costs. Discussion. The high CS rates in China must be paid significant attention. The indicators of two modes of delivery should be regulated strictly. CS rate reduction and saving medical resources will be the benefits if vaginal delivery is chosen by pregnant women.

Sub-National Inequality of Caesarean Section in Urban-Rural Area of Indonesia

“…This is because in mother age over 35 years have a risk of complications in childbirth. This finding is in line with a study by Zhife He et al in China that the proportion of caesarean section delivery in mothers older than 35 years is greater than for normal delivery (He et al, 2016).…”

Practices and obstetric interventions in women from a state in the Northeast of Brazil

“…1,2 The trend towards an increase in the number of cesarean sections is observed worldwide -except for the Netherlands and other European countries, where it is minor -with Brazil as a leader. 3 Two decades ago, the World Health Organization (WHO) published the report "Safe Motherhood" with recommendations on appropriate obstetric practices and those to be avoided. 4 Evidence based on systematic reviews suggests that ambulating and staying in upright positions during the first period of labor reduces the duration of labor, the risk of cesarean section and the use of analgesia, while not posing risks to the mother or the newborn.…”

The initiation of a neuraxial analgesia service on the rate of cesarean delivery in Hubei, China. a 1-year restrospective studyThe initiation of a neuraxial analgesia service on the rate of cesarean delivery in Hubei, China. a 1-year restrospective study

“…The rate of cesarean delivery (CD) in China [1][2][3][4][5] has risen markedly from 2.0% (14/701) in 1978-1985 to 36.6% (813/2224) during 2006-2010 [1] . In the recent years, nearly half of all newborns in China were delivered by CD [2,3] , among which 23.2% were performed based on maternal request cesarean delivery (MRCD) rather than on medical indications [6] . The high rate of overall CD may result in 3 increased risk of maternal complications such as infection, hemorrhage, or even death [6] .…”

“…The high rate of overall CD may result in 3 increased risk of maternal complications such as infection, hemorrhage, or even death [6] . Previous researches have showed that Chinese women choose CD only to avoid the pain during vaginal delivery, because normally no analgesia will be given during their labor and delivery in China [2,7] .…”