The Rates and Medical Necessity of Cesarean Delivery in the Era of the Two-Child Policy in Hubei and Gansu Provinces, China.
Am J Public Health
; 109(3): 476-482, 2019 03.
Article
en En
| MEDLINE
| ID: mdl-30676790
ABSTRACT
OBJECTIVES:
To describe the cesarean rates in different child policy periods and assess the medical necessity of cesareans during the 2-child policy period.METHODS:
We collected hospital-level aggregate data on 93 745 deliveries and individual-level data on 27 977 deliveries from 6 hospitals in the Hubei and Gansu provinces of China from 2013 to 2016. Experts in gynecology and obstetrics assessed the medical necessity of 1024 randomly selected cesareans in 2016.RESULTS:
The overall cesarean rate decreased significantly from 45.1% in the 1-child policy period (January 2013-September 2014) to 40.4% in the selective 2-child policy period (October 2014-July 2016) and further to 38.9% in the universal 2-child policy period (August 2016-December 2016). The rate of cesarean delivery on maternal request decreased by 46.3%, whereas the rate of cesarean delivery indicated by a previous cesarean delivery increased by 118.8% (P < .001). The experts assessed 222 (21.6%) cesareans as lacking medical necessity.CONCLUSIONS:
The overall cesarean rate in Hubei and Gansu provinces decreased after the implementation of the 2-child policy, and one fifth of cesareans might be nonessential.
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Complicaciones del Embarazo
/
Cesárea
/
Tasa de Natalidad
/
Procedimientos Innecesarios
/
Servicios Médicos de Urgencia
/
Política de Salud
Tipo de estudio:
Observational_studies
/
Prevalence_studies
/
Risk_factors_studies
Límite:
Adult
/
Female
/
Humans
/
Pregnancy
País/Región como asunto:
Asia
Idioma:
En
Revista:
Am J Public Health
Año:
2019
Tipo del documento:
Article