Address correspondence to Ke-Zong M. Ma, Ph.D., Assistant Professor, Graduate Institute of Healthcare Administration, Kaohsiung Medical University, 100 Shih-Chuan 1st Road, Kaohsiung 80708, Taiwan; e-mail: firstname.lastname@example.org. Edward C. Norton, Ph.D., Professor, and Shoou-Yih D. Lee, Ph.D., Associate Professor, are with the Department of Health Management and Policy, University of Michigan, Ann Arbor, MI. Edward C. Norton, Ph.D., Professor, is also with the Department of Economics, University of Michigan, Ann Arbor, MI.
Declining Fertility and the Use of Cesarean Delivery: Evidence from a Population-Based Study in Taiwan
Article first published online: 2 JUN 2010
© Health Research and Educational Trust
Health Services Research
Volume 45, Issue 5p1, pages 1360–1375, October 2010
How to Cite
Ma, K.-Z. M., Norton, E. C. and Lee, S.-Y. D. (2010), Declining Fertility and the Use of Cesarean Delivery: Evidence from a Population-Based Study in Taiwan. Health Services Research, 45: 1360–1375. doi: 10.1111/j.1475-6773.2010.01125.x
- Issue published online: 9 SEP 2010
- Article first published online: 2 JUN 2010
- cesarean delivery;
- physician-induced demand;
- multinomial probit model;
Objective. To test the hypothesis that declining fertility would affect the number of cesarean sections (c-sections) on maternal demand, but not medically indicated c-sections.
Data Sources. The 1996–2004 National Health Insurance Research Database in Taiwan for all singleton deliveries.
Study Design. Retrospective population-based, longitudinal study. Estimation was performed using multinomial probit models.
Principal Findings. Results revealed that declining fertility had a significant positive effect on the probability of having a c-section on maternal request but not medically indicated c-section.
Conclusions. Our findings offer a precautionary note to countries experiencing a fertility decline. Policies to contain the rise of c-sections should understand the role of women's preferences, especially regarding cesarean deliveries on maternal request.