International differences in obstetric interventions - Tips from Other Journals

Date: Nov, 1990

International Differences in Obstetric Interventions Notzon conducted a study to compare the worldwide rates of cesarean section, vaginal birth after cesarean section and operative delivery (forceps and vacuum extraction) during the years 1975 through 1985. Questionnaires were sent to government and university researches in 29 countries in Europe, North America, South America and the Pacific. Responses were received from 21 countries or regions.

The cesarean section rates varied widely, from 7 percent in Czechoslovakia to 32 percent in Brazil. In the United States and Canada, the rates were 23 percent and 19 percent, respectively. In most countries, the rate of cesarean sections increased during the ten years and the rate of instrument deliveries decreased. However, a slowing in the increasing rate of cesarean sections was noted in the first half of the 1980s. The rates of vaginal delivery after a cesarean birth were 5 percent and 6 percent in the United States and Canada, but almost 40 percent in Scotland and Bavaria and 46.5 percent in the Netherlands.

In a comparison of cesarean rates for two specific complications of labor and delivery that can be objectively diagnosed (multiple births and breech delivery) worldwide rates rose sharply from 1980 to 1985. No significant relationship was found between rates of obstetric intervention and measures of birth outcome in any country.

While definite conclusions about etiology cannot be drawn from ecologic data, the author believes that the findings indicate that low levels of early infact mortality can be achieved despite a low rate of cesarean deliveries. (JAMA, June 27, 1990, vol. 263, p. 3286.)

COPYRIGHT 1990 American Academy of Family PhysiciansCOPYRIGHT 2004 Gale Group

 
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