Indicator Metadata
- Summary View
- Detailed View
Name |
Low-Risk Caesarean Sections |
Short/Other Names |
Not applicable |
Description |
This indicator measures the rate of deliveries via Caesarean section (C-section) among singleton term cephalic pregnancies for low-risk nulliparous women in spontaneous labour. For further details, please see the General Methodology Notes (PDF). |
Interpretation |
A lower rate for this indicator is desirable |
HSP Framework Dimension |
Health System Outputs: Appropriate and effective |
Areas of Need |
Getting Better |
Geographic Coverage |
All provinces/territories except Quebec |
Reporting Level/Disaggregation |
National, Province/Territory, Region, Facility |
Indicator Results |
Accessing Indicator Results on Your Health System: In Depth (PDF) |
Name |
Low-Risk Caesarean Sections |
Short/Other Names |
Not applicable |
Description |
This indicator measures the rate of deliveries via Caesarean section (C-section) among singleton term cephalic pregnancies for low-risk nulliparous women in spontaneous labour. For further details, please see the General Methodology Notes (PDF). |
Calculation: Description |
The indicator is expressed as the rate of C-sections per 100 deliveries, where a singleton term cephalic delivery was recorded among low-risk nulliparous women in spontaneous labour. Risk-adjusted rate = Observed cases ÷ Expected cases × Canadian average Unit of Analysis: Single admission |
Calculation: Geographic Assignment |
Place of service |
Calculation: Type of Measurement |
Rate - per 100 |
Calculation: Adjustment Applied |
The following covariates are used in risk adjustment: |
Calculation: Method of Adjustment |
Logistic regression |
Denominator |
Description: Inclusions:
Exclusions:
|
Numerator |
Description: Inclusions:
|
Rationale |
In Canada, C-sections have increased 30% since 2000-2001; they accounted for 28% of all deliveries in 2015-2016, which is similar to the rate in other developed countries 1-2. C-sections are usually performed in order to avoid maternal or fetal injury or death in a complicated birth. However, compared with vaginal deliveries, C-sections are associated with increased risks of maternal morbidity 3,4 and higher hospital costs 5. The Society of Obstetricians and Gynaecologists of Canada (SOGC) promotes normal childbirth, without technological interventions, when possible 6. In order to assess appropriateness of care, this indicator focuses on a population of low-risk pregnancies for which a vaginal birth is expected. The SOGC recommends using the Modified Robson classification system to facilitate appropriate comparisons of C-section rates among homogeneous populations;7 this indicator is limited to Modified Robson Group 1 (nullipara, singleton, cephalic, ? 37 weeks, spontaneous labour). Additionally, post-term births and those with maternal and fetal health conditions and other complications of pregnancy are excluded. With the assistance of SOGC clinical experts, the exclusion criteria were largely aligned with those outlined in the Quality-Based Procedures Clinical Handbook for Low Risk Birth 8. Variations in this indicator may reflect differences in clinical practice. This measure is intended to be used as a flag to identify areas for improvement and to help reduce C-section rates. Although the indicator is limited to a very low-risk population, efforts to decrease the rate of C-sections in this population may lead to an overall decrease in C-section rates. |
Interpretation |
A lower rate for this indicator is desirable |
HSP Framework Dimension |
Health System Outputs: Appropriate and effective |
Areas of Need |
Getting Better |
Targets/Benchmarks |
Not applicable |
References |
|
Data Sources | DAD |
Available Data Years |
Type of Year: Fiscal First Available Year: 2015 Last Available Year: 2019 |
Geographic Coverage | All provinces/territories except Quebec |
Reporting Level/Disaggregation | National, Province/Territory, Region, Facility |
Update Frequency | Every year |
Indicator Results |
Web Tool: Your Health System: In Depth URL: Accessing Indicator Results on Your Health System: In Depth (PDF) |
Updates | Not applicable |
Caveats and Limitations | Results are not calculated for Quebec, since parity information is not available for this province. |
Trending Issues | Prior to 2015-2016, parity information was not available for all provinces and territories submitting to the Discharge Abstract Database |
Comments | Not applicable |