Differences and trends in obstetric interventions at term among urban and rural women in New South Wales: 1990-1997.
The aim of this study was to compare the management of term births among rural and urban women, including the effect of indigenous status and out-of-area-birth for rural women. Data were obtained from the NSW Midwives Data Collection (MDC), on 619,298 women who gave birth to a live, singleton infant at term (37-45 weeks gestation) from 1 January 1990 to 31 December 1997. Compared with urban non-indigenous women, rural women and indigenous women had lower rates of obstetric interventions both before birth (induction of labour, planned Caesarean section and epidural) and at the time of birth (Caesarean after labour, instrumental delivery and episiotomy). This was especially true for rural women giving birth in the their local area. The differing pregnancy risk profile of rural women did not explain the differences in intervention rates but differences were partly explained by higher rates of epidural anaesthesia in urban areas.
Roberts
C L
CL
New South Wales Centre for Perinatal Health Services Research, Department of Obstetrics and Gynaecology, and School of Population Health and Health Services Research, University of Sydney, Australia.
Algert
C S
CS
Peat
B
B
Henderson-Smart
D
D
D000328:Adult; D036861:Delivery, Obstetric / Q000379:methods* / Q000706:statistics & numerical data / Q000639:trends*; D006297:Health Services Accessibility / Q000706:statistics & numerical data / Q000639:trends; D006302:Health Services Research; D006801:Humans; D008507:Medically Underserved Area; D009517:New South Wales; D009774:Obstetrics / Q000379:methods* / Q000706:statistics & numerical data / Q000639:trends*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data / Q000639:trends*; D012111:Residence Characteristics / Q000706:statistics & numerical data; D012423:Rural Health / Q000706:statistics & numerical data / Q000639:trends*; D014504:Urban Health / Q000706:statistics & numerical data / Q000639:trends*; D000095283:Australian Aboriginal and Torres Strait Islander Peoples