Caesarian section: a privilege or a necessity?

Caesarian section: a privilege or a necessity?

S. Cali, S. Kalaca

Department of Public Health, University of Marmara, Istanbul, Turkey

Introduction: In Turkey, caesarian section rates are increasing. The

overall caesarian section rate increased from 5.7% in 1988 to 13.9% in 1998. In

Turkey, caesarian section rates are higher for women of high socioeconomic level.

While the WHO suggests an upper limit of 15 % for caesarian section rate, it is

controversial that people spending more money to private sector in order to get

quality care services take more risk. Or, more educated women take more risk

when compared to uneducated women. The question is that: can the caesarian

section be considered as a favour for high socio-economic-level women or as an

inequality in health for the same group; or vice versa.

Aims and Methods: In this study we compared caesarian section rates of

two different types of hospitals in order to find out the related factors. This

descriptive study was conducted in a Governmental Hospital (GH) and in a

University Hospital (UH). All the deliveries during one month period that

occurred in these two hospitals were recruited into study. Data regarding

indications for caesarian section and related factors were collected from

hospital records. SPSS for windows was used for data analysis.

Results: Since we used hospital records, there was limited data about

possible related factors. Therefore we used data of another study to compare two

groups of women regarding their educational level. In the GH; 9.7% of women were

uneducated where the majority of women were primary school graduates. In the UH,

only 3% of women had no education while 58.2% had high school or university

diploma. In GH more than half of the women had no health insurance. In the UH,

caesarian section rate was 36.1 % while it was 28.8% in the GH and the

difference was statistically significant. When we look at the indications, 26.7

% of the caesarian sections were elective in UH, while this figure was 11.8% in


Conclusions: Factors affecting caesarian section should be further

investigated with both qualitative and quantitative studies. This may help to

solve this controversial situation.

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