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J Obstet Gynaecol Can. 2004 Aug;26(8):735-42.

Recent trends in caesarean delivery rates and indications for caesarean delivery in Canada.

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  • 1Health Surveillance and Epidemiology Division, Centre for Healthy Human Development, Health Canada, Ottawa, ON.

Abstract

OBJECTIVE:

To examine recent trends in Caesarean delivery rates as well as the indications for Caesarean delivery in Canada, excluding the provinces of Manitoba and Quebec.

METHODS:

All deliveries (N = 1 807 388) recorded in the Canadian Institute for Health Information's Discharge Abstract Database for the years 1994/95 to 2000/01 were included in the study (all hospital deliveries in Canada except for those occurring in Manitoba and Quebec). Temporal trends and inter-provincial/territorial variations in Caesarean delivery rates were quantified, and the primary indications for Caesarean delivery during the study period were compared.

RESULTS:

The overall Caesarean delivery rate increased from 18.0% in 1994/95 to 22.1% in 2000/01. The primary Caesarean delivery rate increased from 12.7% to 16.3%, while the rate of vaginal birth after Caesarean decreased from 33.3% to 28.5% over the same period. Most of the increase in primary Caesarean deliveries was due to increases in Caesarean deliveries for dystocia, which increased from 6.9% in 1994/95 to 9.2% in 2000/01. The largest increase in repeat Caesarean deliveries was due to elective repeat Caesarean sections, which increased from 37.7% to 40.3%. Approximately 15% of the increase in overall Caesarean delivery rates was explained by increases in maternal age. The rate of vaginal deliveries following forceps rotation declined from 1.9% in 1994/95 to 1.3% in 2000/01.

CONCLUSION:

Most of the recent increase in Caesarean delivery rates in Canada was attributed to increases in primary Caesarean delivery for dystocia and elective repeat Caesarean deliveries.

PMID:
15307978
[PubMed - indexed for MEDLINE]
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