Why 'down under' is a cut above: a comparison of rates of and reasons for caesarean section in England and Australia

Prosser, Samantha J., Miller, Yvette D., Thompson, Rachel and Redshaw, Maggie (2014) Why 'down under' is a cut above: a comparison of rates of and reasons for caesarean section in England and Australia. BMC Pregnancy and Childbirth, 14 1: . doi:10.1186/1471-2393-14-149


Author Prosser, Samantha J.
Miller, Yvette D.
Thompson, Rachel
Redshaw, Maggie
Title Why 'down under' is a cut above: a comparison of rates of and reasons for caesarean section in England and Australia
Journal name BMC Pregnancy and Childbirth   Check publisher's open access policy
ISSN 1471-2393
Publication date 2014-04-01
Year available 2014
Sub-type Article (original research)
DOI 10.1186/1471-2393-14-149
Open Access Status DOI
Volume 14
Issue 1
Total pages 13
Place of publication London, United Kingdom
Publisher BioMed Central
Language eng
Formatted abstract
Background
Most studies examining determinants of rising rates of caesarean section have examined patterns in documented reasons for caesarean over time in a single location. Further insights could be gleaned from cross-cultural research that examines practice patterns in locations with disparate rates of caesarean section at a single time point.

Methods
We compared both rates of and main reason for pre-labour and intrapartum caesarean between England and Queensland, Australia, using data from retrospective cross-sectional surveys of women who had recently given birth in England (n = 5,250) and Queensland (n = 3,467).

Results
Women in Queensland were more likely to have had a caesarean birth (36.2%) than women in England (25.1% of births; OR = 1.44, 95% CI = 1.28-1.61), after adjustment for obstetric characteristics. Between-country differences were found for rates of pre-labour caesarean (21.2% vs. 12.2%) but not for intrapartum caesarean or assisted vaginal birth. Compared to women in England, women in Queensland with a history of caesarean were more likely to have had a pre-labour caesarean and more likely to have had an intrapartum caesarean, due only to a previous caesarean. Among women with no previous caesarean, Queensland women were more likely than women in England to have had a caesarean due to suspected disproportion and failure to progress in labour.

Conclusions
The higher rates of caesarean birth in Queensland are largely attributable to higher rates of caesarean for women with a previous caesarean, and for the main reason of having had a previous caesarean. Variation between countries may be accounted for by the absence of a single, comprehensive clinical guideline for caesarean section in Queensland.
Keyword Caesarean section
Childbirth
Pregnancy
Cross-cultural comparison
Vaginal birth after caesarean
Previous caesarean section
Patient-reported data
Quality improvement
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Article no. 14:149

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2015 Collection
School of Psychology Publications
 
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