Eskicioğlu, Fatma Celal Bayar Üniversitesi - Tıp Fakültesi - Kadın Hastalıkları ve Doğum AD, Turkey , Hasdemir, Pınar Solmaz Celal Bayar Üniversitesi - Tıp Fakültesi - Kadın Hastalıkları ve Doğum AD, Turkey , Çelik, Hakan Merkez Efendi Devlet Hastanesi - Kadın Hastalıkları ve Doğum Kliniği, Turkey , Koyuncu, Faik Mümtaz Celal Bayar Üniversitesi - Tıp Fakültesi - Kadın Hastalıkları ve Doğum AD, Turkey

The effect of health policies on physicians’ decisions to perform caesarean sections: evaluation of a secondary health institution

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Purpose: The Ministry of Health and the Turkish Obstetrics and Gynaecology Association have been working hard to lower the rate of caesarean sections to %15 as recommended by the World Health Organization (WHO). In order to reach this target, the Ministry of Health introduced new policies. The aim of this research was to evaluate the effects of these policies on secondary health institutions with high birth rates in our region. Materials and methods: Our research included hospital records of deliveries made between 2007 and 2012 in Manisa Merkez Efendi State Hospital (formerly; Manisa Doğumevi). The research was carried out in two periods; Group-1 included 2007-2008-2009 years and Group-2 included 2010-2011-2012 years. The number of births and caesarean sections were evaluated during this period. X ² test was used for the statistical analysis and p value of 0.05 was considered significant. Results: The ratio of number of caesarean section / number of total births (5962/13508) was 44.1% in Group-1, while the ratio (4656/11175) was 41.6% in Group-2.The decrease was statistically significant in Group-2 (p 0.001). Primary caesarean section rates (excluding previous uterine scar) was 68% in Group 1, and 51% in group 2.The ratio of primary caesarean section / total number of birth rate was 30% in Group- 1, while in Group-2 it was 21.3%. The most significant decrease of this ratio was in 2012 and it was 13%. Conclusion:Based on these data, it was observed that policies carried out by the Ministry of Health with the support of the TJOD decreased the rates of caesarean sections, especially primary caesarean rates significantly. In conclusion, health policies are effective on decision making of caesarean sections by obstetrics and gynaecologists working at secondary health institutions.

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Caesarean section rate , indication , vaginal delivery.

Pamukkale Medical Journal

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