Private healthcare increases chances of unplanned caesarean section in Australia

on 09 March 2022

According to research, women in Australia are likely to have an unplanned caesarean section if they give birth in a private healthcare setting compared to public healthcare settings.

The study found that women were 4.2% more likely to have an unplanned caesarean section in a private hospital, with the chances increasing to 7.7% in first-time mothers.

The study focussed on a data set of 289,000 births in New South Wales between 2007 and 2012 to approximate a randomised trial. Two-thirds of the women received public healthcare and 27% gave birth in a private hospital, with 7% receiving private obstetric care in a public hospital.

In Australia, women who give birth in a public hospital have care provided by an appointed midwife and obstetrician. If a woman wishes to have an elective caesarean section (without existing health reasons) private healthcare is usually the only option.

This research is the first of its kind to measure the impact on the type of birth having a private obstetrician in a public hospital, as well as the impact of giving birth in a private hospital.

Results showed that having a private obstetricians in a public hospital setting increased the probability of having a caesarean section by 2.1%. This increased to 4.2% if the woman chose to give birth using private healthcare only.

Commenting on the findings, researchers Serena Yu et al said: “Our results have meaningful implications for women choosing their antenatal and birth care, as well as the health system supporting them.

“Women may choose a private obstetrician for reasons of continuity of care or because of recommendation. They may prefer the amenities in a private hospital. Our study adds to the body of evidence about the likelihood of surgical intervention in different settings. Women should seek information about their care choices and advocate for their preferences around intervention with their midwife or doctor.”

The study ‘Private provider incentives in health care: The case of caesarean births’ is currently not open access but the abstract is available here.

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