"There is a misconception that the overall increase of cesarean births is the result of maternal request," says lead author Gillian Hanley, a PhD student in the UBC School of Population and Public Health. "Our analysis of B.C. data shows that this is not the case."
Published in the June issue of the journal Obstetrics & Gynecology, the UBC study examined all deliveries in B.C. between 2004 and 2007 and found an average of 21.2 per 100 deliveries were first-time C-sections and 14.2 per 100 deliveries were assisted vaginal deliveries involving the use of forceps and/or vacuum devices. Dystocia – or abnormal or difficult childbirth – was the most common reason for cesarean deliveries (30 per cent), followed by non-reassuring fetal heart rate (19.1 per cent).
Canada's cesarean delivery rate has increased dramatically over the past two decades, reaching an all time high of 26.3 per cent of in-hospital deliveries in 2005-2006. Until recently, B.C. had the highest cesarean rate in the country, according to the Canadian Institute for Health Information.
The study also found significant regional variations in cesarean and assisted vaginal delivery rates across B.C.'s 16 Health Services Delivery Areas that could not be explained by accounting for medical indications for these procedures. Cesarean delivery rates ranged from 27.5 per cent in the South Vancouver Island area to 16.1 per cent in Kootenay Boundary. Assisted vaginal delivery rates ranged from 18.6 per cent in Vancouver to 8.6 per cent in East Kootenay.
"In other words, some regions are either performing too many or too few cesareans after taking into consideration the characteristics and conditions of the mothers," says Hanley, also a researcher at the UBC Centre for Health Services and Policy Research.
"Our study doesn't attempt to determine the ideal rate of cesarean or assisted vaginal delivery," says Hanley. "But since regional variation is a fundamental principal in assessing the quality of health care, we need to further investigate the reason behind these large differences within the province's system."
The researchers suggest potential reasons may include the differences in practitioners' responses to similar medical situations, such as dystocia, including how they interpret and respond to the condition, and how they factor the resources available to them into their decisions.
"For example, smaller institutions may lack the resources required to respond to medical emergencies in the same manner as a tertiary care facility," says Hanley. "It is therefore more likely for practitioners there to recommend a cesarean delivery with a lower medical threshold.
"These hypotheses should be further investigated and may include non-medical factors such as socio-economic status," says Hanley. "But the findings point to a need for revising current national guidelines regarding the management of dystocia."
Co-authors of the study include Assoc. Prof. Patricia Janssen at the School of Population and Public Health and Devon Greyson, data specialist at the Centre for Health Services and Policy Research.
Brian Lin | EurekAlert!
Study relating to materials testing Detecting damages in non-magnetic steel through magnetism
23.07.2018 | Technische Universität Kaiserslautern
Innovative genetic tests for children with developmental disorders and epilepsy
11.07.2018 | Christian-Albrechts-Universität zu Kiel
There are currently great hopes for solid-state batteries. They contain no liquid parts that could leak or catch fire. For this reason, they do not require cooling and are considered to be much safer, more reliable, and longer lasting than traditional lithium-ion batteries. Jülich scientists have now introduced a new concept that allows currents up to ten times greater during charging and discharging than previously described in the literature. The improvement was achieved by a “clever” choice of materials with a focus on consistently good compatibility. All components were made from phosphate compounds, which are well matched both chemically and mechanically.
The low current is considered one of the biggest hurdles in the development of solid-state batteries. It is the reason why the batteries take a relatively long...
New design tool automatically creates nanostructure 3D-print templates for user-given colors
Scientists present work at prestigious SIGGRAPH conference
Most of the objects we see are colored by pigments, but using pigments has disadvantages: such colors can fade, industrial pigments are often toxic, and...
Scientists at the University of California, Los Angeles present new research on a curious cosmic phenomenon known as "whistlers" -- very low frequency packets...
Scientists develop first tool to use machine learning methods to compute flow around interactively designable 3D objects. Tool will be presented at this year’s prestigious SIGGRAPH conference.
When engineers or designers want to test the aerodynamic properties of the newly designed shape of a car, airplane, or other object, they would normally model...
Researchers from TU Graz and their industry partners have unveiled a world first: the prototype of a robot-controlled, high-speed combined charging system (CCS) for electric vehicles that enables series charging of cars in various parking positions.
Global demand for electric vehicles is forecast to rise sharply: by 2025, the number of new vehicle registrations is expected to reach 25 million per year....
17.08.2018 | Event News
08.08.2018 | Event News
27.07.2018 | Event News
20.08.2018 | Information Technology
20.08.2018 | Life Sciences
20.08.2018 | Information Technology