ArticleEthnicity & health
Caesarean section rates in South Africa: evidence of bias among different 'population groups'.
Article in Ethnicity & health. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 2 of them syntheses that pooled it.
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Who cites it
9 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Meeting need vs. sharing the market: a systematic review of methods to measure the use of private sector family planning and childbirth services in sub-Saharan Africa.BMC health services research · 2018Pooled it
- A systematic review and meta-analysis of studies comparing mortality rates of private for-profit and private not-for-profit hospitals.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2002Pooled it
- Is Birth Method Associated with Sensory Hyperreactivity in Children 3-4 Years in an Upper-Middle-Income Country?Occupational therapy international · 2023Article
- Socioeconomic and migration status as predictors of emergency caesarean section: a birth cohort study.BMC pregnancy and childbirth · 2020Article
- Socio-demographic factors of cesarean births in Nha Trang city, Vietnam: a community-based survey.Tropical medicine and health · 2020Article
- Non-clinical influences on clinical decision-making: a major challenge to evidence-based practice.Journal of the Royal Society of Medicine · 2010Review
- Is generalized maternal optimism or pessimism during pregnancy associated with unplanned cesarean section deliveries in China?Journal of pregnancy · 2010Article
- Cohort Profile: Mandela's children: the 1990 Birth to Twenty study in South Africa.International journal of epidemiology · 2007Review
- Transition from Birth to Ten to Birth to Twenty: the South African cohort reaches 13 years of age.Paediatric and perinatal epidemiology · 2004Article
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Authors and funding
5 authors.
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Abstract
objectiveThe aim of this study was to assess the effect of 'population group' classification, as a specific instance of 'racial' categorization, on caesarean section rates in South Africa.
designInformation on 'population group' classification ('Black, 'Coloured', 'Indian', or 'White', as defined under apartheid legislation) and place of delivery, together with basic obstetric, sociodemographic and perinatal data, were extracted from the birth notification forms of 5456 children who made up the birth cohort of the Birth to Ten longitudinal study. This cohort included all births that occurred to mothers resident in Soweto-Johannesburg during a 7-week period in 1990.
resultsAfter accounting for differences in maternal age, gravidity, birth weight and gestational age at delivery, the rate of caesarean sections at private facilities was more than twice that at public facilities. Although there were significant differences in the utilisation of private facilities by women from different 'population groups', there was an independent effect of 'population group' classification on caesarean section rates: caesarean section rates among women classified as 'White' and 'Coloured' were significantly higher (95% confidence intervals for odds ratios: 1.40-2.42 and 1.05-1.81, respectively) than among women classified as 'Black'.
conclusion'Population group' differences in caesarean section rates among South African women are not explained by differences in demographic risk factors for assisted delivery, nor by differences in access to private health care. Instead, the differences in section rates may reflect the effect of bias in clinical decision-making, and/or differences among women from different 'population groups' in their attitude towards assisted delivery, and their capacity to negotiate with clinicians.
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