Table 5 Obstetrical intervention rates by group allocation and period, and their impact on cesarean section rate
| Â | Intervention group (10 hospitals) | Â | Control group (10 hospitals) | Â | Effect estimates | |||||
|---|---|---|---|---|---|---|---|---|---|---|
Obstetrical interventions | Baseline (N = 5498) | Evaluation (N = 5092) | Rate change% | p value | Baseline (N = 5254) | Evaluation (N = 5429) | Rate change% | p value | Adjusted OR (95%CI) | p value |
All deliveries | ||||||||||
Women without a previous CS | ||||||||||
 Planned cesarean delivery, no. (%) | 1287 (27.3) | 1067 (25.8) | −1.5 | 0.85 | 1177 (26.1) | 1169 (26.0) | −0.1 | 0.07 | 0.9 (0.73, 1.1) | 0.30 |
Women with a previous CS or not | ||||||||||
 Planned cesarean delivery, no. (%) | 2000 (36.4) | 1946 (38.2) | 1.8 | 0.72 | 1855 (35.3) | 2049 (37.7) | 2.4 | 0.03 | 0.85 (0.69, 1.05) | 0.13 |
Labor induction, no. (%) | 1050 (19.1) | 1282 (25.2) | 6.1 | < 0.0001 | 1010 (19.3) | 1347 (24.9) | 5.6 | < 0.0001 | 1.07 (0.77, 1.5) | 0.67 |
Women who attempted labor | ||||||||||
 Total no. | 3498 | 3146 |  |  | 3399 | 3380 |  |  |  |  |
Women without a previous CS | ||||||||||
 Intrapartum cesarean delivery, no. (%) | 307 (8.9) | 222 (7.2) | −1.7 | 0.08 | 312 (9.3) | 234 (7.0) | −2.3 | 0.02 | 1.07 (0.69, 1.64) | 0.76 |
Women with a previous CS or not | ||||||||||
 Intrapartum cesarean delivery, no. (%) | 336 (9.6) | 263 (8.4) | −1.2 | 0.10 | 326 (9.6) | 254 (7.5) | −2.1 | 0.03 | 1.08 (0.74, 1.98) | 0.68 |
Oxytocin during labor, no. (%) | 529 (15.1) | 542 (17.3) | 2.2 | < 0.0001 | 594 (17.5) | 622 (18.5) | 1.0 | 0.31 | 1.32 (0.81, 2.16) | 0.26 |
Epidural analgesia, no. (%) | 1135 (32.6) | 959 (30.6) | −2.0 | 0.002 | 595 (17.6) | 837 (25.7) | 8.1 | < 0.0001 | 0.61 (0.20, 1.81) | 0.36 |
Doula, no. (%) | 1315 (37.6) | 1422 (45.3) | 7.7 | < 0.0001 | 1051 (34.7) | 1115 (37.0) | 2.3 | 0.27 | 1.35 (0.88, 2.08) | 0.17 |
Women without a previous CS | ||||||||||
 Assisted vaginal delivery, no. (%) | 127 (3.7) | 102 (3.3) | −0.4 | 0.77 | 69 (2.1) | 99 (3.0) | 0.9 | 0.03 | 0.61 (0.31, 1.21) | 0.15 |
Women with a previous CS or not | ||||||||||
 Assisted vaginal delivery, no. (%) | 128 (3.7) | 103 (3.3) | −0.4 | 0.77 | 70 (2.1) | 103 (3.1) | 1.0 | 0.03 | 0.6 (0.31, 1.18) | 0.13 |
Episiotomy, no. (%) | ||||||||||
 Median/lateral | 1289 (36.9) | 1006 (32.1) | −4.8 | < 0.0001 | 1532 (45.1) | 1374 (40.7) | −4.4 | 0.69 | 0.78 (0.46, 1.33) | 0.36 |