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PubMed · 16926940

Does having cesarean section capability make a difference to a small rural maternity service?

Nancy Lynch·Harvey Thommasen·Nancy Anderson·Stefan Grzybowski
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Abstract

OBJECTIVE: To determine whether having cesarean section capability in an isolated rural community makes a difference in adverse maternal or perinatal outcomes. DESIGN: Retrospective study comparing population-based obstetric outcomes of two rural remote hospitals in northwestern British Columbia. One hospital had cesarean section capability; one did not. SETTING: Bella Coola General Hospital (with cesarean section capability) in Bella Coola Valley (BCV) and Queen Charlotte Islands General Hospital (without cesarean section capability) in Queen Charlotte City (QCC). PARTICIPANTS: Women who carried pregnancies beyond 20 weeks' gestation and who gave birth between January 1, 1986, and December 31, 2000. INTERVENTIONS: British Columbia Vital Statistics Agency data was used to compare obstetric outcomes in the two communities. A chart audit of local births at BCV and QCC was done to validate the vital statistics data. MAIN OUTCOME MEASURES: Perinatal death, newborn transfer to a tertiary care facility, birth weight, gestational age at delivery, mode of delivery, and Apgar score. RESULTS: The rate of preterm deliveries in QCC was higher (relative risk 1.41, 95% confidence interval 1.00 to 1.99; P = .047) than the rate in BCV. Otherwise, there were no differences in adverse maternal or perinatal outcomes in the two populations. In BCV, 69.8% of women delivered locally compared with 50.2% of women in the southern Queen Charlotte Islands (P < .001). CONCLUSION: Having local cesarean section capability is associated with a greater proportion of local deliveries and a lower rate of preterm deliveries.

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AdolescentAdultAgedBritish ColumbiaCesarean SectionChildChild, PreschoolFemaleHumansInfantInfant MortalityInfant, NewbornMaternal Health ServicesMiddle AgedPregnancyPregnancy OutcomePremature BirthRetrospective StudiesRural Health ServicesComparative StudyJournal Article

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Nancy Lynch, Harvey Thommasen, Nancy Anderson, Stefan Grzybowski. 2005. Does having cesarean section capability make a difference to a small rural maternity service?. https://pubmed.ncbi.nlm.nih.gov/16926940/

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