title: Changes in the cesarean section rate in Korea (1982-2012) and a review of the associated factors.
abstract: Although Cesarean section (CS) itself has contributed to the reduction in maternal and perinatal mortality, an undue rise in the CS rate (CSR) has been issued in Korea as well as globally. The CSR in Korea increased over the past two decades, but has remained at approximately 36% since 2006. Contributing factors associated with the CSR in Korea were an improvement in socio-economic status, a higher maternal age, a rise in multiple pregnancies, and maternal obesity. We found that countries with a no-fault compensation system maintained a lower CSR compared to that in countries with civil action, indicating the close relationship between the CSR and the medico-legal system within a country. The Korean government has implemented strategies including an incentive system relating to the CSR or encouraging vaginal birth after Cesarean to decrease CSR, but such strategies have proved ineffective. To optimize the CSR in Korea, efforts on lowering the maternal childbearing age or reducing maternal obesity are needed at individual level. And from a national view point, reforming health care system, which could encourage the experienced obstetricians to be trained properly and be relieved from legal pressure with deliveries is necessary.
authors.affiliation: Department of Pediatrics, Kyung Hee University School of Medicine, Seoul, Korea.
authors.forename: Sung-Hoon
authors.identifier: 0000-0002-0352-9722
authors.initials: SH
authors.lastname: Chung
authors.affiliation: Department of Obstetrics and Gynecology, Kyung Hee University School of Medicine, Seoul, Korea.
authors.forename: Hyun-Joo
authors.identifier: 0000-0003-0303-7813
authors.initials: HJ
authors.lastname: Seol
authors.affiliation: Department of Pediatrics, Kyung Hee University School of Medicine, Seoul, Korea.
authors.forename: Yong-Sung
authors.identifier: 0000-0001-9181-7849
authors.initials: YS
authors.lastname: Choi
authors.affiliation: Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Soo-Young
authors.identifier: 0000-0003-3002-0048
authors.initials: SY
authors.lastname: Oh
authors.affiliation: Department of Obstetrics and Gynecology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Ahm
authors.identifier: 0000-0002-9285-1106
authors.initials: A
authors.lastname: Kim
authors.affiliation: Department of Pediatrics, Kyung Hee University School of Medicine, Seoul, Korea.
authors.forename: Chong-Woo
authors.identifier: 0000-0002-0965-5674
authors.initials: CW
authors.lastname: Bae
mesh_terms: D002585:Cesarean Section / Q000706:statistics & numerical data* / Q000639:trends; D003625:Data Collection; D005260:Female; D006801:Humans; D007348:Insurance, Health; D007351:Insurance, Liability; D008423:Maternal Age; D009765:Obesity / Q000453:epidemiology; D011247:Pregnancy; D011272:Pregnancy, Multiple / Q000706:statistics & numerical data; D056910:Republic of Korea; D012923:Social Class; D016064:Vaginal Birth after Cesarean / Q000706:statistics & numerical data* / Q000639:trends
keywords: Cesarean Section Rate; Korea; Statistics; Trends