Mothers who book privately are more likely to have caesarean delivery

15 Apr 2014

A research study into private healthcare coverage and increased risk of obstetric intervention has just been published in BMC Pregnancy and Childbirth. 

This study was carried out by the National Perinatal Epidemiology Centre (NPEC) based in the Department of Obstetrics and Gynaecology at University College Cork.

Background

Obstetric interventions, such as caesarean delivery, may be necessary for the health of mothers and babies.  However, the choice to perform these interventions can be affected by clinical and non-clinical reasons.  Researchers examined obstetric intervention rates among mothers who booked privately versus mothers who booked publicly across Ireland between 2005 and 2010. They looked at rates of caesarean delivery, operative vaginal delivery, induction of labour and episiotomy in 403,642 childbirths. Approximately one-third of these childbirths (30.2%) were booked privately.

Key findings

After controlling for common risk factors mothers who booked privately were 48% more likely to have an elective caesarean delivery, 13% more likely to have an emergency caesarean delivery and 25% more likely to have an assisted delivery (forceps or vacuum).   Among mothers with a natural delivery, mothers who booked privately were 40% more likely to have an episiotomy.   The study highlights that further research is needed to better understand both clinical and non-clinical dynamics contributing to these differences.

“To provide the best quality maternity care, we need to understand differences in obstetric practice and avoid unnecessary risks.  It is important that mums are aware of the benefits and risks of different obstetric procedures and feel open to discuss these issues with their maternity care providers,” Ms Jennifer Lutomski National Perinatal Epidemiology Centre, Department of Obstetrics and Gynaecology, University College Cork, chief author.