ArticleBMC pregnancy and childbirth2014
Private health care coverage and increased risk of obstetric intervention.
Article in BMC pregnancy and childbirth, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 3 of them syntheses that pooled it.
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Who cites it
24 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Caesarean section in uninsured women in the USA: systematic review and meta-analysis.BMJ open · 2019Pooled it
- Pooled it
- Pooled it
- Trial
- Neglect of focus on income and private practice in ethics textbooks.Irish journal of medical science · 2026Article
- An implementation analysis of a quality improvement project to reduce cesarean section in Brazilian private hospitals.Reproductive health · 2024Article
- Clinicians' views of factors influencing decision-making for CS for first-time mothers-A qualitative descriptive study.PloS one · 2022Article
- Episiotomy in Southern Brazil: prevalence, trend, and associated factors.Revista de saude publica · 2022Article
- Article
- Factors influencing women's perceptions of choice and control during pregnancy and birth: a cross-sectional study.BMC pregnancy and childbirth · 2021Article
- Financing Maternity and Early Childhood Healthcare in The Australian Healthcare System: Costs to Funders in Private and Public Hospitals Over the First 1000 Days.International journal of health policy and management · 2021Article
- Do you pay to go private?: a single centre comparison of induction of labour and caesarean section rates in private versus public patients.BMC pregnancy and childbirth · 2020Article
- [Outpatient breech birth attendance.]Revista espanola de salud publica · 2020Article
- Article
- Association between caesarean section delivery and obesity in childhood: a longitudinal cohort study in Ireland.BMJ open · 2019Article
- Evidence-based Birth Attendance in Spain: PrivateInternational journal of environmental research and public health · 2019Article
- 'If I do 10-15 normal deliveries in a month I hardly ever sleep at home.' A qualitative study of health providers' reasons for high rates of caesarean deliveries in private sector maternity care in Delhi, India.BMC pregnancy and childbirth · 2018Article
- The Impact of Caesarean Section on the Risk of Childhood Overweight and Obesity: New Evidence from a Contemporary Cohort Study.Scientific reports · 2018Article
- Article
- Clinicians' views of factors of importance for improving the rate of VBAC (vaginal birth after caesarean section): a study from countries with low VBAC rates.BMC pregnancy and childbirth · 2016Article
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWhen clinically indicated, common obstetric interventions can greatly improve maternal and neonatal outcomes. However, variation in intervention rates suggests that obstetric practice may not be solely driven by case criteria.
methodsDifferences in obstetric intervention rates by private and public status in Ireland were examined using nationally representative hospital discharge data. A retrospective cohort study was performed on childbirth hospitalisations occurring between 2005 and 2010. Multivariate logistic regression analysis with correction for the relative risk was conducted to determine the risk of obstetric intervention (caesarean delivery, operative vaginal delivery, induction of labour or episiotomy) by private or public status while adjusting for obstetric risk factors.
results403,642 childbirth hospitalisations were reviewed; approximately one-third of maternities (30.2%) were booked privately. After controlling for relevant obstetric risk factors, women with private coverage were more likely to have an elective caesarean delivery (RR: 1.48; 95% CI: 1.45-1.51), an emergency caesarean delivery (RR: 1.13; 95% CI: 1.12-1.16) and an operative vaginal delivery (RR: 1.25; 95% CI: 1.22-1.27). Compared to women with public coverage who had a vaginal delivery, women with private coverage were 40% more likely to have an episiotomy (RR: 1.40; 95% CI: 1.38-1.43).
conclusionsIrrespective of obstetric risk factors, women who opted for private maternity care were significantly more likely to have an obstetric intervention. To better understand both clinical and non-clinical dynamics, future studies of examining health care coverage status and obstetric intervention would ideally apply mixed-method techniques.
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