Prevalence of spontaneous, induced labour or planned caesarean section and factors associated with caesarean section in low-risk women in southern Brazil

• Published in: Midwifery 2019-12, Vol.79, p.102530-102530, Article 102530
• Main Authors: Velho, Manuela Beatriz, Brüggemann, Odaléa Maria, McCourt, Christine, Freitas, Paulo Fontoura, Gama, Silvana Granado Nogueira da, Costa, Roberta, d'Orsi, Eleonora
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Brazil - epidemiology; Caesarean section; Cesarean Section - statistics & numerical data; Child; Cross-Sectional Studies; Female; Humans; Induction; Labor, Induced - statistics & numerical data; Labor, Obstetric; Labour; Logistic Models; Nursing; Obstetric; Parturition; Pregnancy; Pregnancy Outcome; Prevalence; Young Adult
• ISSN: 0266-6138; 1532-3099
• DOI: 10.1016/j.midw.2019.102530

•Only half (48.0%) of the low-risk women experienced spontaneous labour.•One in seven pregnant women of usual risk were subject to induced labour (14.0%).•More than one third of the women were subject to planned caesarean section (38.0%).•The overall caesarean section rate was 50.5% of low-risk women.•Socioeconomic, obstetric and professional factors associated with planned caesarean section do not justify these patterns of use. This study aimed to examine the prevalence of spontaneous labour, induced labour and planned caesarean section in low-risk women; to identify the contribution of each group to the overall caesarean section rate; and to estimate factors associated with caesarean section in low-risk women according to spontaneous labour, induced labour and planned caesarean section. Cross-sectional hospital-based study of postpartum women and newborns, using data from the survey Birth in Brazil, Southern region. In the sample of 2,668 low-risk women, a descriptive analysis was undertaken and a Multinomial Logistic Regression model was applied to verify associations among caesarean section and spontaneous labour, induced labour and planned caesarean section in comparison with vaginal birth. The results showed the prevalence of spontaneous labour (48.0%), induced labour (14.0%) and planned caesarean sections (38.0%); these frequencies contributed to an overall caesarean section rate of 50.5%. Obstetric characteristics like previous vaginal birth or previous caesarean section were differentially associated with caesarean section, independently of the labour. Caesarean section without labour was significantly associated with age ≥ 35 years (ORadj 5.45 95%CI 3.16–9.39), economic class A and B (ORadj 3.10 95%CI 1.92–4.99), pregnancy between 37 and 38 weeks (ORadj 1.65 95%CI 1.22–2.24), same obstetrician in prenatal and childbirth (ORadj 13.83 95%CI 8.85–21.61) and private payment source at birth (ORadj 11.50 95%CI 6.64–19.93). For low-risk women in Southern Brazil, the results identify high planned caesarean section rates, not associated with socioeconomic, obstetric, institutional or prenatal factors that justify these rates.