The Cesarean Section Rate in Sweden: The End of the Rise

Authors

  • Thorkild F. Nielsen MD, PhD,

    1. Thorkild F. Nielsen is in the Department of Obstetrics and Gynaecology, Central Hospital, Borås, and Ingemar Ingemarsson is in the Department of Obstetrics and Gynaecology, University of Lund. Petra Otterblad Olausson is at the National Board of Health and Welfare, Stockholm, Sweden.
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  • Petra Otterblad Olausson and,

    1. Thorkild F. Nielsen is in the Department of Obstetrics and Gynaecology, Central Hospital, Borås, and Ingemar Ingemarsson is in the Department of Obstetrics and Gynaecology, University of Lund. Petra Otterblad Olausson is at the National Board of Health and Welfare, Stockholm, Sweden.
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  • Ingemar Ingemarsson MD, PhD

    Corresponding author
    1. Thorkild F. Nielsen is in the Department of Obstetrics and Gynaecology, Central Hospital, Borås, and Ingemar Ingemarsson is in the Department of Obstetrics and Gynaecology, University of Lund. Petra Otterblad Olausson is at the National Board of Health and Welfare, Stockholm, Sweden.
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Address correspondence to Ingemar Ingemarsson, MD, Department of Obstetrics and Gynaecology, University of Lund, S-221 85 Lund, Sweden.

Abstract

ABSTRACT: This nationwide study examined the annual changes in cesarean section rates in relation to perinatal mortality, the condition of the newborn at birth, and different indications for the procedure in Sweden. Since 1973 all obstetric units have sent copies of medical birth registration forms for newborns to the National Board of Health and Welfare. Information about the cesarean section rate, indications for the surgery, Apgar scores, and perinatal mortality between 1973 and 1990 was obtained from this data base. The cesarean section rate increased from 5 percent in 1973 to 12.3 percent in 1983, and thereafter declined steadily to 10.84 percent in 1990. Perinatal mortality was halved from 14.2 to 6.3 per 1000 live births, and the number of newborns with low Apgar scores (<4 at 1 min and/or <7 at 5 min) decreased from 20 to 14 per 1000 live births. We conclude that it is possible to lower the cesarean section rate on a nationwide basis without increasing risks to newborn infants.

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