ArticleBulletin of the World Health Organization2007
Delivery settings and caesarean section rates in China.
Article in Bulletin of the World Health Organization, 2007. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 papers, 4 of them syntheses that pooled it.
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Who cites it
44 citing papers in PubMed, 4 syntheses or guidelines pooled it, 144 citations in OpenAlex.
- Caesarean section in uninsured women in the USA: systematic review and meta-analysis.BMJ open · 2019Pooled it
- Pooled it
- Immersion in water during labour and birth.The Cochrane database of systematic reviews · 2018Pooled it
- The effect of an elective cesarean section on maternal request on peripartum anxiety and depression in women with childbirth fear: a systematic review.BMC pregnancy and childbirth · 2017Pooled it
- Exploring spatial clusters of caesarean sections across India - Insights from National Family Health Survey data.PLOS global public health · 2026Article
- Impact of normal vs. caesarean deliveries on child nutritional status and mortality in India: insights from NFHS-5 data.BMC pediatrics · 2024Article
- Using mobile health in primiparous women: effect on awareness, attitude and choice of delivery type, semi-experimental.Reproductive health · 2024Article
- Risk factors of caesarean deliveries in urban-rural areas of Bangladesh.Frontiers in reproductive health · 2023Article
- Association between migration status and caesarean section delivery based on a modified Robson classification in China.BMC pregnancy and childbirth · 2021Article
- Type of anaesthesia for caesarean section and failure rate in Princess Marina Hospital, Botswana's largest referral hospital.African health sciences · 2020Article
- Rural-urban disparities in caesarean section rates in minority areas in China: evidence from electronic health records.The Journal of international medical research · 2020Article
- A Segmented Logistic Regression Approach to Evaluating Change in Caesarean Section Rate with Reform of Birth Planning Policy in Two Regions in China from 2012 to 2016.Risk management and healthcare policy · 2020Article
- Iranian midwives' attitudes and beliefs toward physiological childbirth: a cross-sectional study.BMC pregnancy and childbirth · 2019Article
- Effects of midwife-led maternity services on postpartum wellbeing and clinical outcomes in primiparous women under China's one-child policy.BMC pregnancy and childbirth · 2018Article
- High prevalence of cesarean section births in private sector health facilities- analysis of district level household survey-4 (DLHS-4) of India.BMC public health · 2018Article
- Article
- Association between Cesarean Section and Weight Status in Chinese Children and Adolescents: A National Survey.International journal of environmental research and public health · 2017Article
- Large reductions in cesarean delivery rates in China: a qualitative study on delivery decision-making in the era of the two-child policy.BMC pregnancy and childbirth · 2017Article
- Predictors of preference for caesarean delivery among pregnant women in Beijing.The Journal of international medical research · 2017Article
- Determinants and materno-fetal outcomes related to cesarean section delivery in private and public hospitals in low- and middle-income countries: a systematic review and meta-analysis protocol.Systematic reviews · 2017Article
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo quantify the influence of increasing use of health-care services on rising rates of caesarean section in China.
methodsWe used data from a population-based survey conducted by the United Nations Population Fund during September 2003 in 30 selected counties in three regions of China. The study sample (derived from birth history schedule) consisted of 3803 births to mothers aged less than 40 years between 1993 and 2002. Multiple logistic regression models were used to estimate the effect of health-care factors on the odds of a caesarean section, controlling for time and selected variables.
findingsInstitutional births increased from 53.5% in 1993-1994 to 82.2% in 2001-2002, while the corresponding increase in births by caesarean section was from 8.9% to 24.8%, respectively. Decomposition analysis showed that 69% of the increase in rates of caesarean section was driven by the increase in births within institutions. The adjusted odds of a caesarean section were 4.6 times (95% confidence interval, CI: 3.4-11.8) higher for recent births. The adjusted odds were also significantly higher for mothers who had at least one antenatal ultrasound test. Rates of caesarean section in secondary-level facilities markedly increased over the last decade to the same levels as in major hospitals (P < 0.001).
conclusionThe upsurge in rates of births by caesarean section in this population cannot be fully explained by increases in institutional births alone, but is likely to be driven by medical practice within secondary-level hospitals and women's demand for the procedure.
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