Caesarean birth rates in public and privately funded hospitals: a cross-sectional study
ABSTRACT OBJECTIVE To examine maternal and obstetric factors influencing births by cesarean section according to health care funding. METHODS A cross-sectional study with data from Southeastern Brazil. Caesarean section births from February 2011 to July 2012 were included. Data were obtained fro...
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| Format: | Article |
| Language: | English |
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Universidade de São Paulo
2017-11-01
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| Series: | Revista de Saúde Pública |
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| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-89102017000100294&lng=en&tlng=en |
| _version_ | 1828340480671219712 |
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| author | Bruna Dias Alonso Flora Maria Barbosa da Silva Maria do Rosário Dias de Oliveira Latorre Carmen Simone Grilo Diniz Debra Bick |
| author_facet | Bruna Dias Alonso Flora Maria Barbosa da Silva Maria do Rosário Dias de Oliveira Latorre Carmen Simone Grilo Diniz Debra Bick |
| author_sort | Bruna Dias Alonso |
| collection | DOAJ |
| description | ABSTRACT OBJECTIVE To examine maternal and obstetric factors influencing births by cesarean section according to health care funding. METHODS A cross-sectional study with data from Southeastern Brazil. Caesarean section births from February 2011 to July 2012 were included. Data were obtained from interviews with women whose care was publicly or privately funded, and from their obstetric and neonatal records. Univariate and multivariate analyses were conducted to generate crude and adjusted odds ratios (OR) with 95% confidence intervals (95%CI) for caesarean section births. RESULTS The overall caesarean section rate was 53% among 9,828 women for whom data were available, with the highest rates among women whose maternity care was privately funded. Reasons for performing a c-section were infrequently documented in women’s maternity records. The variables that increased the likelihood of c-section regardless of health care funding were the following: paid employment, previous c-section, primiparity, antenatal and labor complications. Older maternal age, university education, and higher socioeconomic status were only associated with c-section in the public system. CONCLUSIONS Higher maternal socioeconomic status was associated with greater likelihood of a caesarean section birth in publicly funded settings, but not in the private sector, where funding source alone determined the mode of birth rather than maternal or obstetric characteristics. Maternal socioeconomic status and private healthcare funding continue to drive high rates of caesarean section births in Brazil, with women who have a higher socioeconomic status more likely to have a caesarean section birth in all birth settings. |
| first_indexed | 2024-04-13T22:57:09Z |
| format | Article |
| id | doaj.art-de344417ee9d48c3b43350626cfd212f |
| institution | Directory Open Access Journal |
| issn | 1518-8787 |
| language | English |
| last_indexed | 2024-04-13T22:57:09Z |
| publishDate | 2017-11-01 |
| publisher | Universidade de São Paulo |
| record_format | Article |
| series | Revista de Saúde Pública |
| spelling | doaj.art-de344417ee9d48c3b43350626cfd212f2022-12-22T02:25:58ZengUniversidade de São PauloRevista de Saúde Pública1518-87872017-11-0151010.11606/s1518-8787.2017051007054S0034-89102017000100294Caesarean birth rates in public and privately funded hospitals: a cross-sectional studyBruna Dias AlonsoFlora Maria Barbosa da SilvaMaria do Rosário Dias de Oliveira LatorreCarmen Simone Grilo DinizDebra BickABSTRACT OBJECTIVE To examine maternal and obstetric factors influencing births by cesarean section according to health care funding. METHODS A cross-sectional study with data from Southeastern Brazil. Caesarean section births from February 2011 to July 2012 were included. Data were obtained from interviews with women whose care was publicly or privately funded, and from their obstetric and neonatal records. Univariate and multivariate analyses were conducted to generate crude and adjusted odds ratios (OR) with 95% confidence intervals (95%CI) for caesarean section births. RESULTS The overall caesarean section rate was 53% among 9,828 women for whom data were available, with the highest rates among women whose maternity care was privately funded. Reasons for performing a c-section were infrequently documented in women’s maternity records. The variables that increased the likelihood of c-section regardless of health care funding were the following: paid employment, previous c-section, primiparity, antenatal and labor complications. Older maternal age, university education, and higher socioeconomic status were only associated with c-section in the public system. CONCLUSIONS Higher maternal socioeconomic status was associated with greater likelihood of a caesarean section birth in publicly funded settings, but not in the private sector, where funding source alone determined the mode of birth rather than maternal or obstetric characteristics. Maternal socioeconomic status and private healthcare funding continue to drive high rates of caesarean section births in Brazil, with women who have a higher socioeconomic status more likely to have a caesarean section birth in all birth settings.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-89102017000100294&lng=en&tlng=enCesarean Section, statistics & numerical dataHealth care FinancingMaternal-Child Health ServicesSocioeconomic FactorsCross-Sectional Studies |
| spellingShingle | Bruna Dias Alonso Flora Maria Barbosa da Silva Maria do Rosário Dias de Oliveira Latorre Carmen Simone Grilo Diniz Debra Bick Caesarean birth rates in public and privately funded hospitals: a cross-sectional study Revista de Saúde Pública Cesarean Section, statistics & numerical data Health care Financing Maternal-Child Health Services Socioeconomic Factors Cross-Sectional Studies |
| title | Caesarean birth rates in public and privately funded hospitals: a cross-sectional study |
| title_full | Caesarean birth rates in public and privately funded hospitals: a cross-sectional study |
| title_fullStr | Caesarean birth rates in public and privately funded hospitals: a cross-sectional study |
| title_full_unstemmed | Caesarean birth rates in public and privately funded hospitals: a cross-sectional study |
| title_short | Caesarean birth rates in public and privately funded hospitals: a cross-sectional study |
| title_sort | caesarean birth rates in public and privately funded hospitals a cross sectional study |
| topic | Cesarean Section, statistics & numerical data Health care Financing Maternal-Child Health Services Socioeconomic Factors Cross-Sectional Studies |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-89102017000100294&lng=en&tlng=en |
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