• Health services research · Oct 2010

    Declining fertility and the use of cesarean delivery: evidence from a population-based study in Taiwan.

    • Ke-Zong M Ma, Edward C Norton, and Shoou-Yih D Lee.
    • Graduate Institute of Healthcare Administration, Kaohsiung Medical University, 100 Shih-Chuan 1st Road, Kaohsiung 80708, Taiwan. kezong@kmu.edu.tw
    • Health Serv Res. 2010 Oct 1;45(5 Pt 1):1360-75.

    ObjectiveTo test the hypothesis that declining fertility would affect the number of cesarean sections (c-sections) on maternal demand, but not medically indicated c-sections.Data SourcesThe 1996-2004 National Health Insurance Research Database in Taiwan for all singleton deliveries.Study DesignRetrospective population-based, longitudinal study. Estimation was performed using multinomial probit models.Principal FindingsResults revealed that declining fertility had a significant positive effect on the probability of having a c-section on maternal request but not medically indicated c-section.ConclusionsOur findings offer a precautionary note to countries experiencing a fertility decline. Policies to contain the rise of c-sections should understand the role of women's preferences, especially regarding cesarean deliveries on maternal request.Copyright © Health Research and Educational Trust.

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