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Examining Cesarean Section Rates in Canada Using the Modified Robson Classification.

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Area of Science:

  • Obstetrics and Gynecology
  • Public Health
  • Health Services Research

Background:

  • Canada's cesarean delivery (CD) rate is rising.
  • The modified Robson classification system is recommended for comparing CD rates.
  • Understanding national and provincial CD rates is crucial for targeted interventions.

Purpose of the Study:

  • To describe national and provincial cesarean delivery rates in Canada using the modified Robson classification.
  • To identify key Robson groups contributing significantly to the overall CD rate.
  • To establish a benchmark for future initiatives aimed at reducing CD rates.

Main Methods:

  • Analysis of 2016-2017 in-hospital birth data from Canada (excluding Québec) using the Discharge Abstract Database.
  • Categorization of births using the modified Robson classification system.
  • Reporting of CD rates, group sizes, and contributions to overall CD volume, with provincial and hospital peer group analysis.

Main Results:

  • A total of 286,201 births were analyzed, with 29.1% resulting in cesarean delivery.
  • Robson group 5 (term singleton previous CD) had the highest CD rate (80.5%) and was the largest contributor (36.6%) to overall CDs.
  • Induced labor (group 2A) had a CD rate nearly double spontaneous labor (group 1) (33.5% vs. 18.4%), with both groups being significant contributors to overall CDs.

Conclusions:

  • Significant variations in CD rates exist across Canadian provinces and hospitals.
  • Focusing on high-contributing Robson groups (5, 2A, and 1) offers insights for CD rate reduction strategies.
  • This study provides a vital benchmark for evaluating future efforts to decrease cesarean delivery rates in Canada.