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
GH.
Conclusions: Factors affecting caesarian section should be further
investigated with both qualitative and quantitative studies. This may help to
solve this controversial situation.
