The Rates and Medical Necessity of Cesarean Delivery in the Era of the Two-Child Policy in Hubei and Gansu Provinces, China

Bibliographic Data

ID11039391
AuthorsZijun Liao (0000-0002-3082-0646, Zijun Liao, Yubo Zhou, Hongtian Li, and Jianmeng Liu are with the Institute of Reproductive and Child Health/Ministry of Health Key Laboratory of Reproductive Health, and the Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China. Cheng Wang is with the Gansu Provincial Maternity and Child-Care Hospital, Lanzhou, Gansu, China. Dunjin Chen is with the Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.), Yubo Zhou (0000-0002-0696-1123, Zijun Liao, Yubo Zhou, Hongtian Li, and Jianmeng Liu are with the Institute of Reproductive and Child Health/Ministry of Health Key Laboratory of Reproductive Health, and the Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China. Cheng Wang is with the Gansu Provincial Maternity and Child-Care Hospital, Lanzhou, Gansu, China. Dunjin Chen is with the Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.), Hongtian Li (0000-0002-9972-0838, Zijun Liao, Yubo Zhou, Hongtian Li, and Jianmeng Liu are with the Institute of Reproductive and Child Health/Ministry of Health Key Laboratory of Reproductive Health, and the Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China. Cheng Wang is with the Gansu Provincial Maternity and Child-Care Hospital, Lanzhou, Gansu, China. Dunjin Chen is with the Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.), Cheng Wang (0000-0002-4693-6424, Zijun Liao, Yubo Zhou, Hongtian Li, and Jianmeng Liu are with the Institute of Reproductive and Child Health/Ministry of Health Key Laboratory of Reproductive Health, and the Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China. Cheng Wang is with the Gansu Provincial Maternity and Child-Care Hospital, Lanzhou, Gansu, China. Dunjin Chen is with the Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.), Dunjin Chen (0000-0002-1839-3469, Zijun Liao, Yubo Zhou, Hongtian Li, and Jianmeng Liu are with the Institute of Reproductive and Child Health/Ministry of Health Key Laboratory of Reproductive Health, and the Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China. Cheng Wang is with the Gansu Provincial Maternity and Child-Care Hospital, Lanzhou, Gansu, China. Dunjin Chen is with the Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.), Jianmeng Liu (0000-0002-3220-6084, Zijun Liao, Yubo Zhou, Hongtian Li, and Jianmeng Liu are with the Institute of Reproductive and Child Health/Ministry of Health Key Laboratory of Reproductive Health, and the Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China. Cheng Wang is with the Gansu Provincial Maternity and Child-Care Hospital, Lanzhou, Gansu, China. Dunjin Chen is with the Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.)
Year2019
Volume109
Issue3
Pages476-482
Publication date2019-03-01
Open AccessNo
TypeARTICLE
VenueAmerican Journal of Public Health (JOURNAL)
Journal identifiersISSN: 0090-0036 • E-ISSN: 1541-0048
PublisherAmerican Public Health Association (PUBLISHER • US)
DOI10.2105/ajph.2018.304868
PMID30676790
OpenAlexW2911940979
LanguageEN
Citations received2
References cited16

Objectives. To describe the cesarean rates in different child policy periods and assess the medical necessity of cesareans during the 2-child policy period. Methods. We collected hospital-level aggregate data on 93 745 deliveries and individual-level data on 27 977 deliveries from 6 hospitals in the Hubei and Gansu provinces of China from 2013 to 2016. Experts in gynecology and obstetrics assessed the medical necessity of 1024 randomly selected cesareans in 2016. Results. The overall cesarean rate decreased significantly from 45.1% in the 1-child policy period (January 2013–September 2014) to 40.4% in the selective 2-child policy period (October 2014–July 2016) and further to 38.9% in the universal 2-child policy period (August 2016–December 2016). The rate of cesarean delivery on maternal request decreased by 46.3%, whereas the rate of cesarean delivery indicated by a previous cesarean delivery increased by 118.8% (P Conclusions. The overall cesarean rate in Hubei and Gansu provinces decreased after the implementation of the 2-child policy, and one fifth of cesareans might be nonessential

Cesarean delivery · China · Family medicine · Obstetrics · Political science · Pregnancy · Demography · Global Maternal and Child Health · Maternal and Perinatal Health Interventions · Medicine · Neonatal and fetal brain pathology · Pediatrics

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