Authors

Margo S. Harrison, University of Colorado School of Medicine
Sarah Saleem, Aga Khan University
Sumera Ali, Aga Khan University
Omrana Pasha, Aga Khan University
Elwyn Chomba, University of Zambia
Waldemar A. Carlo, University of Alabama at Birmingham
Ana L. Garces, Unidad de Planificación Instituto de Nutrición de Centroamérica y Panamá
Nancy F. Krebs, University of Colorado School of Medicine
K. Michael Hambidge, University of Colorado School of Medicine
Shivaprasad S. Goudar, KLE University's Jawaharlal Nehru Medical College
S. M. Dhaded, KLE University's Jawaharlal Nehru Medical College
Bhala Kodkany, KLE University's Jawaharlal Nehru Medical College
Richard J. Derman, Thomas Jefferson UniversityFollow
Archana Patel, Lata Medical Research Foundation
Patricia L. Hibberd, Boston University
Fabian Esamai, Moi University School of Medicine
Edward A. Liechty, Indiana University School of Medicine
Antoinette Tshefu, Kinshasa School of Public Health
Adrien Lokangaka, Kinshasa School of Public Health
Melissa Bauserman, University of North Carolina School of Medicine
Carl L. Bose, University of North Carolina School of Medicine
Fernando Althabe, Institute for Clinical Effectiveness and Health Policy
Jose M. Belizan, Institute for Clinical Effectiveness and Health Policy
Pierre Buekens, Tulane School of Public Health and Tropic Medicine,
Janet L. Moore, RTI International
Dennis D. Wallace, RTI International
Menachem Miodovnik, Eunice Kennedy Shriver National Institute of Child Health and Human Development
Marion Koso-Thomas, Eunice Kennedy Shriver National Institute of Child Health and Human Development
Elizabeth M. McClure, RTI International
Robert L. Goldenberg, Columbia University

Document Type

Article

Publication Date

6-1-2019

Comments

This article has been peer reviewed. It is the authors' final version prior to publication in American Journal of Perinatology, Volume 36, Issue 7, June 2019, Pages 730-736.

The published version is available at https://doi.org/10.1055/s-0038-1673656. Copyright © Thieme

Abstract

OBJECTIVE: Few data are available on cesarean delivery and operative vaginal delivery trends in low- and middle-income countries. Our objective was to analyze a prospective population-based registry including eight sites in seven low- and middle-income countries to observe trends in operative vaginal delivery versus cesarean delivery rates over time, across sites.

STUDY DESIGN: A prospective population-based study, including home and facility births among women enrolled from 2010 to 2016, was performed in communities in Argentina, Democratic Republic of Congo, Guatemala, India, Kenya, Pakistan, and Zambia. Women were enrolled during pregnancy and delivery outcome data were collected.

RESULTS: We analyzed 354,287 women; 4,119 (1.2%) underwent an operative vaginal delivery and 45,032 (11.2%) delivered by cesarean. Across all sites with data for 7 years, rates of operative vaginal delivery decreased from 1.6 to 0.3%, while cesarean delivery increased from 6.4 to 14.4%. Similar trends were seen when individual country data were analyzed. Operative vaginal delivery rates decreased in both hospitals and clinics, except in the hospital setting at one of the Indian sites.

CONCLUSION: In low- and middle-income countries, operative vaginal delivery is becoming less utilized while cesarean delivery is becoming an increasingly common mode of delivery.

Language

English

Available for download on Monday, June 01, 2020

Share

COinS