253575 Caesarian-Sections (C-Sections) and Vaginal Deliveries in Hawaii: 2005-2009

Monday, October 31, 2011

Nancy S. Partika, RN, MPH , Office of Public Health Studies, University of Hawaii-Manoa, HPM Faculty, Honolulu, HI
Eric L. Hurwitz, DC, PhD , Office of Public Health Studies, University of Hawaii, Honolulu, HI
Problem: Almost one-third of Hawaii's births are to women on Medicaid, however little is known about how their maternal and child health (MCH) outcomes, including delivery methods, compared with privately-insured women, who represent over half of all births,

Study Purpose: A descriptive analysis on 88,000 Hawaii births was completed to (1) identify factors associated with delivery method (C-section versus vaginal delivery) and (2) estimate the associations between delivery method, insurance status (Medicaid versus private insurance) and Caesarian sections (C-sections) versus vaginal deliveries outcome. This is the last of a 4-part analysis of labor and delivery data from Hawaii's birthing hospitals.

Method: Hospital discharge data representing all births in Hawaii hospitals from January 1, 2005 through June 30, 2009 were linked (mother to baby), extracted, and analyzed. Descriptive and inferential statistics were computed on mother and newborn variables to identify factors and estimate associations.

Findings: Compared to women with vaginal deliveries (73%), C-section mothers (27%) were more likely to be white, on private health care insurance/non-Medicaid, living in a rural area outside of Honolulu, and diagnosed with hypertension or gestational diabetes. Premature and high or very low birth-weight infants were more likely to be delivered via C-section than vaginally.

Implications: Findings suggest that there are socio-demographic, insurance-related and medical outcome-related variables in the prevalence of C-sections versus vaginal deliveries occurring in Hawaii.

Learning Areas:
Clinical medicine applied in public health
Other professions or practice related to public health
Provision of health care to the public

Learning Objectives:
By the end of this presentation, the learner will be able to: 1. Describe the study methods and the variables analyzed in Hawaii births from 2005-2009. 2. Identify 2-3 variables of C-section versus vaginal deliveries for women giving birth in Hawaii from 2005-2009. 3. Discuss 1-2 potential implications of this data on Hawaii birth outcomes.

Keywords: Birth Outcomes, Women's Quality Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because I am a professor of epidemiology and teach analytic methods in maternal and child health.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.