Caesarean deliveries in China.

Area of Science:

• Obstetrics and Gynecology
• Public Health
• Health Services Research

Background:

• China has experienced a rapid increase in caesarean section rates.
• Understanding the drivers of this trend is crucial for public health initiatives.

Purpose of the Study:

• To estimate caesarean section rates and indications across different hospital facility levels in Mainland China.
• To identify factors contributing to the high caesarean section rate.

Main Methods:

• A retrospective, cross-sectional, hospital-based study was conducted.
• Data were collected from 112,138 births in 39 hospitals (20 tertiary, 19 secondary) across 14 provinces in 2011.

Main Results:

• The overall caesarean section rate was 54.5%, higher in tertiary (55.9%) than secondary (50.9%) hospitals.
• Non-indicated caesarean sections comprised 38.4% of all caesarean sections, with higher rates in secondary hospitals (48.9%) compared to tertiary hospitals (34.5%).
• Caesarean section on maternal request was more prevalent in secondary hospitals (16.6%) than tertiary hospitals (10%).

Conclusions:

• Caesarean section on maternal request is a major contributor to China's high caesarean section rates, particularly in secondary hospitals.
• Reducing non-indicated caesarean sections is the primary strategy for lowering overall caesarean section rates.