12noon – 1pm, Thursday 11th December 2008
Melbourne School of Population Health, Seminar Room 515, Level 5, 207 Bouverie Street, Carlton
This WIP will review a study-in-progress that is tackling an important public health issue and trying to develop new methods for quantifying predictors of rate changes. Caesarean section rates have risen sharply in many countries since the 1990s, with particularly large increases over the last decade. Between 1996 and 2005, for example, rates increased by 36% in Australia (up to 30% of all births), 28% in the United Kingdom (up to 23% of births) and 32% in the United States (up to 30% of births). Victoria tracks the national trend closely: less than 1 in 5 births was a caesarean section in 1999; by 2006, it was nearly 1 in 3. Although many previous studies have examined predictors of delivery by caesarean section, only a few have sought to measure the importance of various drivers of rate changes over time. Using data on deliveries by elective caesarean section in Victoria between 1999 and 2006, we aimed to identify specific clinical and demographic factors behind the state’s rapid increase. Births subsequent to caesarean section are very likely to be by the same method; obstetricians generally try to avoid a “VBAC” (vaginal birth after caesarean). We hypothesised that the proportion of women giving birth who had previously had a caesarean section—which more than doubled in Victoria over the study period—would prove to be particularly influential. If the hypothesis is correct, it creates the possibility of an interesting epidemiological phenomenon: caesarean sections may be trapped in a positive feedback loop. In other words, rising global caesarean rates may, to some extent, be self-propelled.
All welcome. No RSVP required.
All enquiries to Kellie Vizard, Tel: 03 8344 0671
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