Caesarean-section rates in Australia: a population-based audit.

Area of Science:

• Obstetrics and Gynaecology
• Public Health
• Health Services Research

Background:

• Rising caesarean-section rates are a global concern, particularly in Western countries.
• Significant interstate variations in caesarean-section rates exist within Australia.
• Previous research indicates potential links between caesarean rates and specialist availability.

Purpose of the Study:

• To investigate the disparities in caesarean-section rates among Australian states.
• To explore the relationship between the proportion of specialist obstetricians and caesarean-section rates.
• To compare perinatal mortality rates in relation to caesarean-section rates across states.

Main Methods:

• Analysis of private health fund data from Australian states.
• Comparative analysis of caesarean-section rates between Western Australia and South Australia.
• Examination of stillbirth and perinatal mortality rates in relation to caesarean-section prevalence.

Main Results:

• Marked differences in caesarean-section rates were observed between Australian states.
• A potential correlation was identified between caesarean-section rates and the per capita proportion of specialist obstetricians.
• While stillbirth rates were lower in high-caesarean-section states, overall perinatal mortality rates showed no significant difference.

Conclusions:

• The homogeneity of the Australian population makes the justification for performing more caesarean sections questionable.
• Interstate variations in caesarean-section rates may be influenced by the availability of specialist obstetricians.
• Further investigation is warranted to understand the drivers of caesarean-section rates and their impact on perinatal outcomes.