What Is the Safest Population-Level Caesarean Delivery Rate? A National Cohort Study Using Natural Variation.

ABSTRACT:

Objective

Ten to fifteen per cent has been proposed for many decades as the optimal level of caesarean section, with little supporting data. Norway provides a natural experiment in which local variations in the use of caesarean section can be related to health outcomes in the context of free access to high-quality medical services.

Design

Prospective national cohort.

Setting

Norway.

Population

Norwegian deliveries 1995-2014.

Methods

We calculated annual rates of caesarean delivery and health outcomes for 435 municipalities. To avoid hospital referral bias, the mother's municipality of residence was the unit of analysis. Caesarean-delivery rates in each year were based on the 2 years before and after, avoiding indication bias. Analyses were adjusted for y

SUBMITTER: Moster D 

PROVIDER: S-EPMC12358162 | biostudies-literature | 2025 Jul

REPOSITORIES: biostudies-literature