Assessment of Medicalization of Pregnancy and Childbirth in Low-risk Pregnancies: A Cross-sectional Study.
Shadi Sabetghadam, Afsaneh Keramat, Shahrbanoo Goli and 2 others
PMID 35005042WHAT IT FOUND
In low-risk births, 67.1% had cesarean.
Obstetrician-led care, early hospitalization, and more ultrasounds were associated with cesarean; freedom of movement was associated with vaginal birth. This is association, not cause.
Key findings
01Of 337 low-risk women, 226 (67.1%) had cesarean birth.
02After adjustment for age, education, parity, and complementary insurance, prenatal care from an obstetrician was associated with about 2.3 times higher odds of cesarean (OR=2.23), hospitalization before labor with more than twice the odds (OR=2.08), and increased number of ultrasounds with 25% higher odds (OR=1.25).
03Freedom of movement in labor was significantly associated with mode of childbirth (P=0.012).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was cross-sectional, so it could not show that any intervention caused cesarean birth. Participants were selected by convenience sampling from one public hospital, so results may not apply to other settings. Childbirth process data came from medical records rather than direct observation, so details may be incomplete or inaccurate. 129 women had a previous cesarean birth, and repeat cesarean was routine in the setting, which may influence the association between obstetrician care and cesarean birth. Women reported on discharge day, and some information may depend on memory, although records were reviewed to reduce recall bias.
Declared interests
The study was supported by grant No 9761 from Shahroud University of Medical Sciences. The authors declared no conflict of interest.
The easy way to misread this
Do not conclude that obstetrician-led care, early hospitalization, or more ultrasounds caused cesarean. This was a cross-sectional study, so it shows association, not cause.