posted on 2015-08-12, 00:00authored byBeverley A. Lawton, Abby Koch, James Stanley, Stacie E. Geller
Objective: To examine whether changing to a midwifery-led maternity service model
was associated with a lower national rate of cesarean delivery.
Methods: We analyzed trends in the rate of cesarean delivery per 1000 live births
between 1996 and 2010 in New Zealand. Estimates of relative increases in rate were
calculated via Poisson regression for several maternal age groups over the study
period.
Results: Rates of cesarean delivery increased over the study period, from 156.9 per
1000 live births in 1996 to 235 per 1000 in 2010: a crude increase of 49.8%.
Increasing trends were apparent in each age group, with the largest increases
occurring before 2003 and relatively stable rates in the subsequent period. The
smoothed estimate showed that the increase in cesarean rate across all age groups
was 43.7% (95% confidence interval, 41.6–45.8) over the 15-year period.
Conclusion: A national midwifery-led care model was not associated with a
decreased rate of cesarean delivery but, instead, with an increase similar to that in
other high-resource countries. This indicates that other factors may account for the
increase. Further research is needed to examine maternity outcomes associated
with different models of maternity care.
History
Publisher
International Journal of Gynecology and Obstetrics