Published in:
Open Access 01-12-2018 | Research article
Caesarean section rate and postnatal bed occupancy: a retrospective study replacing assumptions with evidence
Published in: BMC Health Services Research | Issue 1/2018
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Background
Obstetric units across the UK face resource pressures alongside a rising rate of Caesarean section (CS). It is assumed that this places a further burden in the form of postnatal bed demands. The number of inpatient beds has fallen nationally, and this may be used to justify attempts to restrict the CS rate. We set out to replace such assumptions with evidence. We did not find any similar contemporary analysis in a literature search.
Methods
The postnatal length of stay (LOS) of women delivering at Watford General Hospital, a large unit hosting around 5500 deliveries per annum, was stratified by mode of delivery. Differences within and across time periods were analysed.
Results
The CS rate rose from 14.5% in 1995 to 30.9% in 2015. The mean LOS post-CS declined from 4.2 to 2.4 days. These data were statistically significant to p < 0.001. Over this period the standardised total postnatal bed use for all delivery modes fell from 11083 days to 7894 days. A 113% rise in the CS rate was accommodated by only a 19.8% rise in postnatal bed use attributable to CS patients.
Conclusions
Whatever pressures may be exacerbated by the rising CS rate, bed occupancy is not one of them. In discussion we widen our argument to suggest that resource pressures should not be used to justify limitations in the CS rate.