Declining fertility and the use of cesarean delivery: Evidence from a population-based study in Taiwan

摘要

Objective. To test the hypothesis that declining fertility would affect the number of cesarean sections (c-sections) on maternal demand, but not medically indicated c-sections. Data Sources. The 1996-2004 National Health Insurance Research Database in Taiwan for all singleton deliveries. Study Design. Retrospective population-based, longitudinal study. Estimation was performed using multinomial probit models. Principal Findings. Results revealed that declining fertility had a significant positive effect on the probability of having a c-section on maternal request but not medically indicated c-section. Conclusions. Our findings offer a precautionary note to countries experiencing a fertility decline. Policies to contain the rise of c-sections should understand the role of women's preferences, especially regarding cesarean deliveries on maternal request.