-- Randy Dotinga
WEDNESDAY, May 18 (HealthDay News) -- Richer women are more
likely to choose to deliver their babies by cesarean section than
poorer women, a switch from the past when the reverse was the case,
a new Scottish study has found.
Cesarean sections are often recommended when women face
difficult deliveries or complications because of diabetes or
preeclampsia, a life-threatening increase in blood pressure. But
the surgery is associated with higher risks and extra costs.
In the United States, cesarean deliveries reached a record high
in 2008, accounting for almost one-third of births, previous
The authors of the new study looked at births in Scotland during
three time periods: 1980-1981, 1990-1991 and 1999-2000. Their
findings are published in the May 18 online edition of the journal
BMC Public Health.
"Thirty years ago, mothers having cesarean sections were more likely to come from deprived areas and/or from a lower social background. This was true for both elective and emergency sections," study co-author Ruth Dundas, a researcher with the Medical Research Council/Chief Scientist Office, Social and Public Health Sciences Unit, said in a news release from the journal's publisher.
"Ten years later, the rates had changed so that, although women from a lower social background were more likely to have emergency sections, there was no difference between them and women from a higher social background in elective surgery rates," Dundas added. "By 1999-2000, the rates had equalized for emergency section, but babies born by elective surgery were more likely to belong to mothers from the higher of the social classes measured."
The trend toward greater equality between social classes when it
comes to emergency cesareans "reflects increased equality in health
care," Dundas pointed out. But, she noted, that doesn't explain the
differences in regard to elective surgeries.
Commenting on the study findings, Dr. Andrei Rebarber, clinical
associate professor at New York University School of Medicine, said
that education level -- which is linked to income -- is playing a
major role in the choices of women to deliver by C-section in the
"The lay press has attributed elective cesarean sections to a combination of medical, legal and patient choice issues," Rebarber said. "However, it seems likely that patient preference has become an ever-increasing factor in the overall cesarean delivery rate."
Rebarber suggested that there needs to be better education of
doctors and patients about the risks and benefits of different
approaches to childbirth.
For more about
cesarean births, visit the U.S. National Library of Medicine.
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