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Modest Rise in Caesarean Section from 2000-2010: The Dutch Experience
Yanjun Zhao1, Jun Zhang1, Chantal Hukkelhoven2
1MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital,Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Plos One
|May 19, 2016
Summary
The Dutch caesarean delivery (CD) rate remained stable due to specific practices. These include external cephalic version for breech births and encouraging vaginal birth after a previous uterine scar.
Area of Science:
- Obstetrics and Gynecology
- Perinatal Health
- Public Health Policy
Background:
- Caesarean delivery (CD) rates have increased globally, yet the Netherlands maintains a relatively low rate.
- Understanding the factors contributing to this stability is crucial for global maternal health strategies.
Purpose of the Study:
- To analyze trends in caesarean delivery (CD) rates across various subgroups of women in the Netherlands from 2000 to 2010.
- To identify specific obstetric practices associated with the stable Dutch CD rate.
Main Methods:
- Analysis of 1,935,959 women from the nationwide Perinatal Registry of the Netherlands (2000-2010).
- Categorization of women into ten groups based on a modified CD classification scheme.
- Description of CD rate trends within each subgroup.
Main Results:
- Overall CD rate increased slightly from 14.0% to 16.7% between 2000-2001 and 2010.
- Significant decreases in fetal and neonatal mortality rates (40-50%) were observed during the study period.
- Specific subgroup findings include a 9.9% CD rate for nulliparous women with spontaneous labor and vertex presentation, and a 45.9% vaginal delivery success rate for multiparous women with a previous uterine scar undergoing a trial of labor.
Conclusions:
- External cephalic version for breech presentation is a key factor in managing CD rates.
- Maintaining low CD rates in nulliparous women and promoting trial of labor for multiparous women with prior uterine scars contribute to overall CD rate stability.
