Reducing cesarean births at a primarily private university hospital
American Journal of Obstetrics and GynecologyPublished 1 June 1993
Michael L. Socol, Patricia Garcia, Alan M. Peaceman, Sharon L. Dooley
Citations94
SJR quartileQ1
SJR score2.77
SNIP2.75
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TL;DR
The cesarean section rate has been significantly reduced for both private and clinic patients, and a decline in operative deliveries for dystocia and an increase in vaginal birth after prior ces Harean section were the principal factors contributing to the lower rates.
Abstract
The cesarean section rate has been significantly reduced for both private and clinic patients. Differences in population demographics and individual physician practice patterns contributed to a higher incidence of cesarean birth on the private service.
Keywords
MedicineHealth Professions
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It is concluded that individual practice style may be an important determinant of the wide variations in the rates of cesarean delivery among obstetricians.
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A large increase in the cesarean birth rate in the United States during the last 10 years has been a source of concern to both obstetricians and the general public.
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Consideration of indications shows that the threefold difference in cesarean birth rate which now exists between Dublin and similar centers across the United States can be accounted for almost entirely by a different approach to management of labor in nulliparous women, compounded by rigid adherence to the precept "once a section, always a section".
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Of these, formal programs aimed at modifying practices within individual hospitals appear to be the most successful, however, insufficient research has been conducted to compare conclusively the impact and feasibility of these six strategies, pointing to the need for further study.
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Current cesarean rates can be substantially reduced without sacrificing fetal and newborn safety, according to the study population.
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Pulmonary embolism and cardiopulmonary arrest during general anesthesia were the leading causes of death in this series and preventive measures aimed at reducing these complications may reduce deaths after cesarean section.
Birth1989 U.S. Cesarean Section Rate Steadies—VBAC Rate Rises to Nearly One in Five
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The 25 years of rising cesarean delivery rates in the United States may have finally run their course, as the rate in 1989 was not significantly different from that in 1988, and the percentage of vaginal births after cESarean section showed a remarkable rise.
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Today, 88% of pregnancies has a physiological course during which just basic care is provided, while in 12% of cases there is a high-risk pregnancy that requires additional assistance and specific.
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It is concluded that there is little evidence that the use of cesarean section for the delivery of very low—birth weight infants, independent of maternal or fetal compromise, improves overall survival.
JAMAPhysician Bias in Cesarean Sections
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It is suggested that modern obstetric practice per se does not increase cesarean section rates, but may shift the distribution of indications for cesAREan section.
Survey of AnesthesiologyRelation of Private or Clinic Care to the Cesarean Birth Rate
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