Rising rates, changing relationships: caesarean section and its correlates in South Korea, 1988-2000

Objective To examine the trends in the relationship between caesarean section rates in South Korea and its correlates. Design Five rounds (1988, 1991, 1994, 1997 and 2000) of population-based National Fertility and Family Health Survey of South Korea. Setting South Korea. Sample Mothers (N = 9184) aged 15-44 years. Methods Caesarean rates were calculated according to correlates and then directly adjusted to five-year age and parity groups. Distribution of all samples (9184 mothers) was standard, producing age- and parity-adjusted caesarean rates. Linear trends of correlates with caesarean rates were examined for ordinal variables such as education, income, urbanisation level (area of residence) and level of prenatal visits. Main outcome measure Age- and parity-adjusted caesarean section rates. Results As caesarean rates rose by year, the relationship of caesarean section with education, occupation and area of residence has been reversed. Associations between caesarean rates, income level, place of delivery and level of prenatal visit were found in 1988 but disappeared by 2000. In 2000, relatively low caesarean rates were found in variables that will be more prevalent in the future, such as higher maternal education, higher maternal occupation and residence in big cities. Conclusion Caesarean rates may have reached a plateau in South Korea. No maternal or health service factors were detected to further increase the proportion of caesarean deliveries.