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Assessing maternity care access: impacts on cesarean sections and dystocia
Soo Hyun Kang1, Minah Park2, Jong Youn Moon3,4
1Gachon Biomedical and Convergence Institute, Gachon University Gil Medical Center, Incheon, South Korea.
BMC Pregnancy and Childbirth
|August 22, 2024
Summary
Maternity care access challenges in South Korea correlate with increased C-sections and dystocia. Improving access to obstetric services is crucial for reducing high-risk pregnancies and complications.
Area of Science:
- Public Health
- Obstetrics & Gynecology
- Health Services Research
Background:
- South Korea faces declining birthrates, intensifying maternity care accessibility issues.
- Maternity care disparities are a growing concern, impacting labor interventions and pregnancy complications.
Purpose of the Study:
- To investigate the association between maternity care accessibility and pregnancy complications, specifically Cesarean sections (C-sections) and dystocia.
- To analyze maternity disparities in South Korea, focusing on outcomes in obstetrically underserved areas.
Main Methods:
- Analysis of 1,437,186 childbirths in South Korea (2010-2015) using NHIS-NID data.
- Identification of 50 Obstetrically Underserved Areas (OUAs) designated by the Ministry of Health and Welfare.
- Logistic regression analysis to assess the association between OUAs and C-section/dystocia rates, using medical procedure, DRG, and ICD-10 codes.
Main Results:
- Women in underserved areas experienced higher rates of C-sections (OR: 1.11) and dystocia (OR: 1.07) nationwide.
- In urban areas, residing in OUAs increased C-section odds (OR: 1.16) and dystocia odds (OR: 1.10).
- These findings indicate a significant link between limited maternity care access and adverse pregnancy outcomes.
Conclusions:
- Poor accessibility to maternity care facilities is strongly associated with increased rates of dystocia and C-sections.
- Insufficient access elevates the risk of severe pregnancy complications, highlighting existing disparities.
- Multi-faceted interventions are urgently needed to address and mitigate maternity care access disparities.
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