| Rates of successful vaginal delivery after cesarean for patients with private versus public insurance. | |
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MedLine Citation:
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PMID: 10685196 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To examine the effect of insurance status on method of delivery while controlling for clinical and sociodemographic characteristics of women delivering at a single medical center. STUDY DESIGN: Sociodemographic and clinical characteristics of 878 women, who delivered their infants between 1985 and 1991 at a university hospital, were analyzed. Women were included if their previous infant was delivered by cesarean section and if the current pregnancy was > or = 37 weeks' gestation at nonemergent delivery with insurance status clearly specified. The outcome of interest was the rate of successful vaginal births after cesarean (VBAC) delivery by insurance status. RESULTS: The trial of labor rate for the cohort, defined as the rate of VBAC or cesarean deliveries following labor, was 55%; 61% were vaginal deliveries. Significant differences with regard to insurance status and several maternal factors were noted between trial of labor and cesarean section--no labor groups. After controlling for potentially confounding variables, the Medicaid/indigent group was more likely than the privately insured group to undergo a trial of labor (odds ratio, 1.5; 95% confidence interval, 1.1 to 2.4). Of women who underwent a trial of labor, after controlling for other characteristics, the Medicaid/indigent group was more likely than the privately insured group to deliver vaginally (odds ratio, 1.9; 95% confidence interval, 1.1 to 3.2). CONCLUSION: After controlling for other covariables, women with a history of a prior cesarean section with Medicaid/indigent insurance were more likely than privately insured women to attempt a trial of labor, and subsequently, to deliver vaginally, given that a trial of labor was attempted. |
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Authors:
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C L Wagner; A K Metts |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Journal of perinatology : official journal of the California Perinatal Association Volume: 19 ISSN: 0743-8346 ISO Abbreviation: J Perinatol Publication Date: 1999 Jan |
Date Detail:
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Created Date: 2000-03-09 Completed Date: 2000-03-09 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8501884 Medline TA: J Perinatol Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 14-8 Citation Subset: IM |
Affiliation:
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Children's Hospital, Department of Pediatrics, Medical University of South Carolina, Charleston 29425, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Female Hospitals, University Humans Insurance, Health* Medicaid Medical Indigency New York Pregnancy Trial of Labor United States Vaginal Birth after Cesarean / economics, utilization* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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