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Large Variations in C-Section Rates Seen in British Columbia

Regional differences in cesarean section, assisted vaginal delivery rates unexplained

TUESDAY, May 25 (HealthDay News) -- There is a large, unexplained variation in rates of cesarean deliveries across the 16 health service delivery districts of British Columbia, Canada, according to research published in the June issue of Obstetrics & Gynecology.

Gillian E. Hanley, of the University of British Columbia in Vancouver, Canada, and colleagues studied all deliveries from the 16 Health Service Delivery Areas in British Columbia from 2004 to 2007, with the exclusion of all women who had a previous cesarean section, resulting in a study sample of 116,839.

The researchers found that dystocia was the indication for 30 percent of cesarean deliveries; this percentage varied more than five-fold across the 16 regions. After controlling for maternal characteristics and conditions that increase the risk of cesarean and assisted vaginal delivery, the investigators found that the adjusted rates of cesarean deliveries ranged from 14.7 to 27.6 per 100 deliveries, and the adjusted rates of assisted vaginal deliveries ranged from 6.5 to 15.3 per 100 deliveries in the 16 regions.

"Our results illustrate substantial regional variation in the use of cesarean delivery that cannot be explained by patient illness or preferences," the authors write. "This variation likely reflects differences in practitioners' approaches to medical decision-making."

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