Norwegian midwives and doctors have increased cesarean section rates

Increasing cesarean section (CS) rates over the last 3 decades may, in part, be explained by improved obstetric procedures, but socio-economic factors also play a major role. Much attention has been given to professionals' attitudes to operative delivery, and several studies have been performed to clarify the issue. The present study explored CS rates among Norwegian doctors and midwives, compared to other professionals with an education of 17-18 years (doctors) and 15-16 years (midwives).

Data on mode of delivery notified to the Medical Birth Registry of Norway for 1969-1998 (n=1,733,665) were linked with data on formal education from Statistics Norway. CS rates and crude and adjusted odds ratios (ORs) were calculated for the observation period.

Female doctors and midwives had higher CS rates; the crude ORs were 1.18 (95% CI: 1.12-1.28) for doctors, and 1.35 (95% CI: 1.21-1.49) for midwives. Adjusted for age and birth order, the ORs were 1.22 (95% CI: 1.12-1.33) for doctors and 1.14 (95% CI: 1.03-1.27) for midwives.

From 1969 to 1998, Norwegian female doctors and midwives had higher CS rates than other professionals with an education of comparable duration.