title: Trends in Indigenous and non-Indigenous caesarean section births in the Northern Territory of Australia, 1986-2012: a total population-based study.
abstract: OBJECTIVE
  To examine trends in caesarean section deliveries and factors associated with these trends for Indigenous and non-Indigenous mothers.
  
  
  METHODS
  Total population-based study.
  
  
  METHODS
  Northern Territory of Australia, 1986-2012.
  
  
  METHODS
  Pregnancies among Northern Territory residents, limited to singleton live births with cephalic presentations delivered at 37-42 weeks' gestation (n = 78 561).
  
  
  METHODS
  Descriptive analyses of demographic and obstetric risk factors. Poisson regression with robust variance to estimate the likelihood of caesarean delivery with and without labour compared with vaginal delivery, over time and between Indigenous and non-Indigenous mothers, adjusting for risk factors.
  
  
  METHODS
  Trends in caesarean sections and risk of caesarean delivery compared with vaginal delivery.
  
  
  RESULTS
  The total rate of caesarean deliveries in the Northern Territory increased between 1986 and 2012. From the year 2000, the rise was driven by increases in caesareans with labour among nulliparous mothers and no labour caesareans among multiparous mothers. Increases in demographic and obstetric risk factors explained the rise in caesareans with labour among nulliparous Indigenous mothers, whereas other unmeasured variables contributed to the rise among non-Indigenous mothers. Increases in previous caesarean delivery contributed to the rise in all caesareans among multiparous mothers. Following adjustment, the risk of Indigenous nulliparous mothers having a caesarean with labour was 47% greater than for non-Indigenous nulliparous mothers [adjusted risk ratio 1.47 (95% CI 1.34-1.60)].
  
  
  CONCLUSIONS
  Increases in demographic and obstetric risk factors partially explained the increase in caesarean rates in the Northern Territory and the contribution of these factors differed between Indigenous and non-Indigenous mothers.
  
  
  CONCLUSIONS
  Caesarean section rates increased between 1986 and 2012 in the Northern Territory of Australia.
authors.affiliation: Department of Health, Northern Territory Government, Darwin, NT, Australia. fintan.thompson@jcu.edu.au.|School of Public Health, Faculty of Medicine and Biomedical Sciences, University of Queensland, Brisbane, Qld, Australia. fintan.thompson@jcu.edu.au.|The Centre for Chronic Disease Prevention, The Cairns Institute, James Cook University, Cairns, Qld, Australia. fintan.thompson@jcu.edu.au.
authors.forename: F
authors.initials: F
authors.lastname: Thompson
authors.affiliation: Department of Health, Northern Territory Government, Darwin, NT, Australia.|Australia Menzies School of Health Research, Charles Darwin University, Casuarina, NT, Australia.
authors.forename: K
authors.initials: K
authors.lastname: Dempsey
authors.affiliation: School of Public Health, Faculty of Medicine and Biomedical Sciences, University of Queensland, Brisbane, Qld, Australia.
authors.forename: G
authors.initials: G
authors.lastname: Mishra
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000639:trends*; D005260:Female; D006801:Humans; D015876:Northern Territory; D016017:Odds Ratio; D010298:Parity; D016012:Poisson Distribution; D011247:Pregnancy; D012044:Regression Analysis; D012307:Risk Factors; D014219:Trial of Labor; D055815:Young Adult
keywords: Caesarean section; Indigenous; trends