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Prenatal care and socioeconomic status: effect on cesarean delivery

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  • Carine Milcent

    () (PSE - Paris School of Economics, PJSE - Paris Jourdan Sciences Economiques - UP1 - Université Panthéon-Sorbonne - ENS Paris - École normale supérieure - Paris - INRA - Institut National de la Recherche Agronomique - EHESS - École des hautes études en sciences sociales - ENPC - École des Ponts ParisTech - CNRS - Centre National de la Recherche Scientifique)

Abstract

Cesarean deliveries are widely used in many high-and middle-income countries. This overuse both increases costs and lowers quality of care and is thus a major concern in the healthcare industry. The study first examines the impact of prenatal care utilization on cesarean delivery rates. It then determines whether socioeconomic status affects the use of prenatal care and thereby influences the cesarean delivery decision. Using exclusive French delivery data over the 2008-2014 period, with multilevel logit models, and controlling for relevant patient and hospital characteristics, we show that women who do not participate in prenatal education have an increased probability of a cesarean delivery compared to those who do. The study further indicates that attendance at prenatal education varies according to socioeconomic status. Low socioeconomic women are more likely to have cesarean deliveries and less likely to participate in prenatal education. This result emphasizes the importance of focusing on pregnancy health education, particularly for low-income women, as a potential way to limit unnecessary cesarean deliveries. Future studies would ideally investigate the effect of promoting programs such as care participation on cesarean delivery rates.

Suggested Citation

  • Carine Milcent, 2018. "Prenatal care and socioeconomic status: effect on cesarean delivery," PSE Working Papers halshs-01724086, HAL.
  • Handle: RePEc:hal:psewpa:halshs-01724086
    Note: View the original document on HAL open archive server: https://halshs.archives-ouvertes.fr/halshs-01724086
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    References listed on IDEAS

    as
    1. Najlla Nassery & Jodi Segal & Eva Chang & John Bridges, 2015. "Systematic Overuse of Healthcare Services: A Conceptual Model," Applied Health Economics and Health Policy, Springer, vol. 13(1), pages 1-6, February.
    2. Grant, Darren, 2009. "Physician financial incentives and cesarean delivery: New conclusions from the healthcare cost and utilization project," Journal of Health Economics, Elsevier, vol. 28(1), pages 244-250, January.
    3. Jeffrey J. Rous & R. Todd Jewell & Robert W. Brown, 2004. "The effect of prenatal care on birthweight: a full-information maximum likelihood approach," Health Economics, John Wiley & Sons, Ltd., vol. 13(3), pages 251-264.
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    Cited by:

    1. Saad Zbiri & Patrick Rozenberg & François Goffinet & Carine Milcent, 2018. "Cesarean delivery rate and staffing levels of the maternity unit," Post-Print halshs-01960301, HAL.

    More about this item

    Keywords

    Pregnancy care; Health education; Socioeconomic position; Cesarean delivery;

    JEL classification:

    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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