High rates of caesarean section in Chile do not reflect patient choice

December 14, 2000

Relation between private health insurance and high rates of caesarean section in Chile: qualitative and quantitative study

In Chile, the rate of caesarean sections in women with private health insurance is double that of those in the public sector, yet this does not reflect patients' choice, according to a study in this week's BMJ.

Between 1995 and 1997, Susan Murray of University College London studied the day to day organisation, norms and relationships in private sector maternity care in Santiago, Chile, to examine the link between private health insurance - which has been promoted in Chile since the 1980s - and high rates of caesarean section.

Women with private obstetricians showed consistently higher rates of caesarean section than those cared for by midwives or doctors on duty in public or university hospitals. However, only a minority of women receiving private care reported that they had wanted this method of delivery.

Private health insurers require an obstetrician, rather than a midwife, to be the primary care provider. The need to provide such a high level of personalised care often conflicts with the demanding work schedules of obstetricians who take on private work to increase their incomes. As a result, the "programming" (or scheduling) of births by induction of labour or elective caesarean is a common time management strategy, says the author. Indeed, the study found that elective caesarean section is more common in women with private obstetricians (30-68%) than women not attended by a private obstetrician (12-14%).

Policies on healthcare financing can influence maternity care management and outcomes in unforseen ways, says the author. The prevailing business ethos in health care encourages such pragmatism among those doctors who do not have a moral objection to non-medical caesarean section.

Susan Murray, Lecturer, Centre for International Child Health, Institute of Child Health, University College London, UK
Email: s.murray@ich.ucl.ac.uk


Related Caesarean Section Articles from Brightsurf:

Risk of childhood asthma by caesarean section is mediated through the early gut microbiome
New study highlights long-term perturbations of the early gut microbiome as a possible mechanism for the observed association between caesarean section and increased risk of developing asthma.

During COVID-19 first wave, the proportion of caesarean section deliveries done under
New research from north-west England published in Anaesthesia (a journal of the Association of Anaesthetists) shows that during the first wave of COVID-19, the proportion of caesarean section deliveries carried out under general anaesthesia approximately halved, from 7.7% to 3.7%.

Caesarean birth, prolonged labour influence infant gut bacteria, risk of childhood obesity
Events at birth may affect the microbes living in a baby's gut during the first few months of life, leading to a higher risk of childhood obesity and allergies, according to a new study published in the journal Gastroenterology.

Fecal transplantation can restore the gut microbiota of C-section babies
Birth by Cesarean section is detrimental to normal gut microbiota development.

Women who deliver by C-section are less likely to conceive subsequent children
Women who deliver their first child by cesarean section (C-section) are less likely to conceive a second child than those who deliver vaginally, despite being just as likely to plan a subsequent pregnancy, according to Penn State College of Medicine researchers.

Caesarean birth has little impact on children developing allergies
A caesarean birth had little impact on whether a child would go onto develop allergies, a new study has shown.

Different views on vaginal birth after previous caesarean section (VBAC)
There is considerable variations in different countries┬┤ health care systems and professionals in the views on vaginal birth after previous caesarean section (VBAC), according to a European study.

Outcomes of birth options after a previous cesarean section
A large cohort study of women who have had one or more previous cesarean sections suggests that attempting a vaginal birth in a subsequent pregnancy is associated with higher health risks to both the mother and the infant than electing for another cesarean.

Death rates from cesarean section far higher in developing countries
Cesarean sections are disproportionately threatening the lives of women and babies in low and middle-income countries (LMIC), according to a study led by Queen Mary University of London.

Altered microbiome after caesarean section impacts baby's immune system
Together with colleagues from Sweden and Luxembourg, scientists from the Luxembourg Centre for Systems Biomedicine (LCSB) of the University of Luxembourg have observed that, during a natural vaginal birth, specific bacteria from the mother's gut are passed on to the baby and stimulate the baby's immune responses.

Read More: Caesarean Section News and Caesarean Section Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.