Cesarean sections in Alberta from April 1979 to March 1988.

OBJECTIVES

To determine (a) trends in the cesarean section rate in Alberta from April 1979 to March 1988, (b) the contribution of different primary indications to the overall increase in the cesarean section rate and (c) trends in the cesarean section rate by residence of the mother.

DESIGN

Retrospective study.

PARTICIPANTS

Women who gave birth in acute care hospitals in Alberta during the study period. Indications for cesarean section were defined by a hierarchic classification system. Geographic regions were identified according to the mother's residence.

MAIN RESULTS

The crude cesarean section rate increased from 13.2 to 17.3 per 100 deliveries between 1979-80 and 1987-88. Previous cesarean section accounted for 54% of the increase, breech presentation for 17%, fetal distress for 17% and dystocia for 10%. The contribution of previous cesarean section was due to the substantial increase in the number of women presenting with a previous cesarean section. The cesarean section rate among women who had previously had the procedure decreased from 96.7% in 1979-80 to 84.6% in 1987-88. The crude cesarean section rates by region varied from 10.3 to 22.3 per 100 deliveries.

CONCLUSIONS

Further efforts to reduce the rate of cesarean section among women who have previously undergone the procedure are needed to control the rate of cesarean section in Alberta. Decreasing the rate of primary cesarean section is also an important goal.