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- Title
Decision on Cesarean Can Often Be Influenced By Nonclinical Factors.
- Authors
Remez, L.
- Abstract
The article notes that nonclinical factors figure prominently in the clinical decision to perform either a vaginal delivery after a cesarean or a repeat cesarean. An analysis of 1986 birth data for California shows that repeat cesarean section rates are highest in for-profit proprietary hospitals, nonteaching hospitals, hospitals with a low obstetric caseload and among privately insured patients. These findings remain statistically significant after potentially confounding clinical and noncinical factors are controlled for. Moreover, findings from a Washington State study using data from 1986 and 1987 indicate that despite the absence of complications, older women giving birth for the first lime are more than twice as likely as comparable younger women to deliver by cesarean section; this suggests that maternal age alone greatly influences the clinical decision to perform a cesarean. Women giving birth in nonprofit University of California hospitals were nearly six times as likely as those delivering in for-profit hospitals to have a vaginal birth after a cesarean section; rates of vaginal births in the large group-practice Kaiser Permanente health maintenance organization were four times higher.
- Subjects
VAGINAL birth after cesarean; DELIVERY (Obstetrics); CESAREAN section; PROPRIETARY hospitals; PATIENTS; OLDER women; CHILDBIRTH
- Publication
Family Planning Perspectives, 1991, Vol 23, Issue 4, p191
- ISSN
0014-7354
- Publication type
Article
- DOI
10.2307/2135749