Abstract
Abstract Objectives: describe mothers, pregnancies and newborns’ characteristics according to the type of childbirth history and to analyze repeated cesarean section (RCS) and vaginal delivery after cesarean section (VBACS), in São Paulo State in 2012. Methods: data are from the Sistema de Informações sobre Nascidos Vivos (Live Birth Information Systems). To find the RCS’s group, the current type of childbirth equal to cesarean section was selected and from these all the previous cesareans. To identify the VBACS’s group all live birth with current vaginal delivery were selected and from these all previous cesareans. Mothers with a history of RCS and VBACS were analyzed according to the characteristics of the pregnancy, newborn and the childbirth hospital. Results: 273,329 mothers of live birth with at least one previous child were studied. 43% of these were born of RCS and 7.4% of VBACS. Mothers who underwent RCS are older and higher educated and their newborns presented a lower incidence of low birth weight. Early term was the most frequent rating for gestational age born of RCS. Live births were of VBACS and had greater proportions of late term. The RCS was more common in hospitals not affiliated with the Sistema Único de Saúde (SUS) (Public Health System) (44.1%). Conclusion: the high RCS’s rates, especially in the private sector, highlight the necessity of improvements in childbirth care model in São Paulo.
Highlights
Cesarean section is a procedure to be performed in situations where maternal-fetal conditions do not favor vaginal delivery, and as in any surgical intervention it is not free of potential complications
Of the 273,329 mothers’ of live births (LB) with at least one previous child, almost 56% were born of cesarean section, which 43% were by repeated cesarean section (RCS) and 13% by cesarean after vaginal delivery (CAVD), indicating that mothers of LBs with a history of cesarean section have a higher chance (PR= 3.26; CI95%=3.23-3.29; p
As for the 44.1% LBs of vaginal delivery, 36.7% were by repeated vaginal delivery (RVD) and a small number (7.4%) were born of VBACS
Summary
Cesarean section is a procedure to be performed in situations where maternal-fetal conditions do not favor vaginal delivery, and as in any surgical intervention it is not free of potential complications. It has been progressively increasing worldwide and is considered endemic in Brazil.[1-3]. In Brazil, overall cesarean section rates have increased from 38% in 2001 to 48.8% in 2008 in several States, and in the private health sector they range from 80% to 90%.1-3. The increase in cesarean sections is because of clinical recommendations or to improve perinatal outcomes. Among the factors associated with cesarean sections, the occurrence of prior cesarean stands out as one of the major determinants of procedure in Brazil[5] and worldwide.[6]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
