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Role of public and private funding in the rising caesarean section rate: a cohort study
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  • Published on:
    Maternal choice and macrosomia are likely significant contributors to CS rates

    In the UK, the rate of maternal request caesareans is also higher in private hospitals, and up until November 2011 (when NICE guidance[1] on Caesarean Section changed) maternal request was not on its own supported as an indication for CS in public (NHS) hospitals; therefore many women, who could afford to, paid for their maternal request caesarean privately.

    Unfortunately, despite the fact that NICE guidance now...

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    Conflict of Interest:
    None declared.
  • Published on:
    Re:Maternal age as a confounder

    I think you very much for your comment on the article. In response to your comment I have now re-analysed the pre-labour caesarean section rates according to age group, ie for women under the age of 30 and women over 29.

    The separate results for these two age groups showed exactly the same pattern as for the groups combined. For example, the caesarean section rate for women over 29 years of age increased by...

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    Conflict of Interest:
    None declared.
  • Published on:
    Maternal age as a confounder

    I acknowledge the authors attempts to correct for confounders such as placenta pravia and breech in this interesting paper, but also think that the significant known confounding effect of maternal age (some references below) and effects on mode of delivery should also have been addressed.

    Am J Obstet Gynecol. 1987 Feb;156(2):305-8. Maternal age and primary cesarean section rates: a multivariate analysis. Martel M,...

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    Conflict of Interest:
    None declared.