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Study shows lower cesarean rate in China

Research finds lower cesarean rate in China than previously thought.

By Amy Wallace 
New study from New York University shows that cesarean section rates are less than previously thought in China and comparable to rates in the United States. Sanjasy/PixaBay
Researchers at New York University have found a lower rate of cesarean section in China than previously reported by a World Health Organization, or WHO, study.
A study in 2010 from the WHO reported that 46.2 percent of babies born in China were delivered by cesarean section. The results were alarming since overuse of cesarean sections is risky for the health of mother and baby and China makes up about one-fifth of the world's population.
However, a 2014 study by Dr. Jan Blustein, professor of Health Policy and Population Health at New York University, found that the current rate of cesarean section was significantly lower than the WHO study, 34.9 percent. The cesarean rate in the United States in 2014 was 32.2 percent.
Reasons for the discrepancy were due to the WHO study focusing primarily on a small number of hospitals located in cities while the NYU study examined births throughout China. Cesarean rates are higher in Chinese cities than in rural areas and nearly half of the population of China live outside of cities.
"Variations in delivery practices are opportunities for improvement," Dr. Llu, senior co-author, professor of Epidemiology and Biostatistics and director of the Institute of Reproductive and Child Health at Peking University, said in a press release. "In areas where cesarean rates are very low, we can provide training and other resources to make sure that cesarean is available when needed. In cities where rates are high, efforts can be targeted to encourage vaginal delivery, when it is appropriate."
The study was the first to document large geographic variations in cesarean rates across various geographic areas of China. Research found that "supercities" rates were above 50 percent with some rural areas having rates less than 20 percent.
The research also found large geographic variations in cesarean rates in the U.S., with a 22.6 percent cesarean rate in Alaska and a roughly 38.8 percent rate in New Jersey in 2010.
"We don't know exactly what drives these variations in delivery patterns in the U.S. -- it could have to do with doctor's and hospital's financial incentives, fears of malpractice claims, sheer convenience for obstetricians, or patient preferences," Blustein said. "Our Chinese colleagues say that the same set of factors are at play in China."
The study was published, which was a collaboration between U.S. and Chinese researchers, was published in JAMA.

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