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Obstet Gynecol. 1994 May;83(5 Pt 1):741-4.

Factors predicting elective repeat cesarean delivery.

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  • 1Eau Claire Family Practice, University of Wisconsin HS07012-01.

Abstract

OBJECTIVE:

To determine which factors influence a trial of labor after previous cesarean delivery.

METHODS:

Among 8829 deliveries at five participating hospitals, the charts of 1001 women who had a previous cesarean delivery were reviewed to determine whether a trial of labor or elective cesarean had been performed. Bivariate analysis compared demographic factors, and logistic regression adjusted for other possible influential variables.

RESULTS:

Fifty-eight percent of the women underwent a trial of labor. Although obstetric variables did not differ between the groups, those undergoing a trial of labor were significantly more likely to be younger, non-white, unmarried, to have no one in the household employed, and to lack private insurance. When logistic regression was performed, only the site of care (odds ratio 0.36-0.52 depending on the site; P < .05) and private insurance (odds ratio 0.52, P < .0001) were independent predictors of a trial of labor.

CONCLUSIONS:

Local factors and insurance status are important in determining whether a woman receives a trial of labor or elective cesarean delivery. These issues must be addressed if reduction of the national cesarean rate is to be realized.

PMID:
8164936
[PubMed - indexed for MEDLINE]
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