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Does Elective Caesarean Section Increase Utilization of Postpartum Maternal Medical Care?

Liu, Tsai-Ching PhD*†; Chen, Chin-Shyan PhD†‡; Lin, Herng-Ching PhD§

doi: 10.1097/MLR.0b013e31816493e9
Brief Report

Background: There have been no studies that quantitatively assess postpartum maternal medical care utilization for elective caesarean section (CS) versus vaginal delivery procedures.

Methods: This study used population-based data linked with birth file data to explore the association between delivery modes (elective CS vs. vaginal delivery) and the utilization of postpartum maternal medical care (outpatient visits and inpatient care) during the 6-month postdelivery period. The analysis was restricted to term deliveries to avoid biased estimation.

Results: The average number of postpartum outpatient visits for elective CS (3.14) was slightly higher than the average number of visits for vaginal deliveries (2.87). Similarly, the total amount of postpartum maternal medical expenditures involved was slightly higher for elective CS than for vaginal deliveries [NT$2811 (US$73.6) vs. NT$2570 (US$71.4)]. The likelihood of postpartum outpatient visits taking place within the 6-month postdelivery period was also slightly higher for elective CS than for vaginal deliveries (77% vs. 70%). The regression results showed that elective CS was associated with significantly higher utilization of maternal medical care compared with vaginal deliveries.

Conclusions: Although the difference between elective CS and vaginal deliveries in terms of postpartum medical care utilization is statistically significant, the small magnitude of the difference in cost (NT$72; US$2.2) suggests that it may not be clinically significant, and may only be marginally important from a policy perspective.

From the *Department of Public Finance, National Taipei University; †Taipei Municipal Wan Fang Hospital; ‡Department of Economics, National Taipei University; and §School of Health Care Administration, Taipei Medical University, Taipei, Taiwan.

Supported by the National Science Council of Republic of China, Taipei, Taiwan (NSC96-2416-I-305-008-MY3) and by Fulbright grant (G68431007).

Reprints: Herng-Ching Lin, PhD, School of Health Care Administration, Taipei Medical University, 250 Wu-Hsing St., Taipei 110, Taiwan. E-mail:

© 2008 Lippincott Williams & Wilkins, Inc.