Implications of Private Practice in Public Hospitals on the Cesarean Rate in Thailand

Abstract

Cesarean section rate in developed countries increased significantly during 1971-1990. In Thailand the rate increased steadily from 15.2% in 1990 to 22.4% in 1996. Cesarean section rate increases with the decline of vaginal delivery, as opera-tive delivery (vacuum and forceps) remained unchanged. There is limited evidence on Thai Cesarean procedures. Anecdotal evidence on high cesarean among private patients leads to a census of all delivery in June 1998 in 29 provincial hospitals, using an interview questionnaire by obstetric nurses with permission of the obstetric department head. An obvious magnitude, 37.2% of patients pay unofficial gratitude money for obstetrician personal delivery services.