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Ethnic disparities in repeat caesarean rates at A uckland H ospital
Author(s) -
Wise Michelle R.,
Anderson Ngaire H.,
Sadler Lynn
Publication year - 2013
Publication title -
australian and new zealand journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.734
H-Index - 65
eISSN - 1479-828X
pISSN - 0004-8666
DOI - 10.1111/ajo.12078
Subject(s) - medicine , ethnic group , childbirth , demography , caesarean delivery , obstetrics , gestational diabetes , caesarean section , body mass index , pregnancy , family medicine , gestation , genetics , pathology , sociology , anthropology , biology
Background N ew Z ealand guidelines recommend that information regarding childbirth choices be given to women with previous caesarean, so they can make informed decisions about their care. We hypothesised that rates of trial of labour ( TOL ) and vaginal birth after caesarean ( VBAC ) would vary by women's ethnicity. Aim To estimate the association of ethnicity with TOL and VBAC rates. Materials and methods Clinical data were used to identify women who gave birth at A uckland H ospital in 2006–2009 with history of previous caesarean eligible for TOL . Multivariable models were used to estimate the association of women's characteristics (ethnicity, age, socio‐economic status ( SES ), height, body mass index, lead maternity carer, diabetes, hypertension, haemorrhage, labour induction, gestational age) with rates of TOL and VBAC . Results In the study cohort of 2400 women, the TOL rate was 39.5%; the VBAC rate was 57.4%. Pacific women were twice as likely to have TOL , while A sian and non‐ N ew Z ealand E uropean women were half as likely to have VBAC , compared with N ew Z ealand E uropean women. Women in more deprived areas were more likely to have TOL , but SES was not associated with VBAC rates. Women under the care of private obstetricians were least likely to have TOL or VBAC . Conclusions There are ethnic disparities in TOL and VBAC rates at our hospital. Strategies need to be developed to ensure that women of all ethnicities have access to both options for mode of delivery.