Women in Australia are more likely to have an unplanned caesarean birth if they give birth in a private hospital rather than a public hospital – independent of their health status during pregnancy or their birth plans. Our recent study showed an unplanned caesarean birth was 4.2% more likely in a private hospital compared with a public hospital. For first-time mums, it was 7.7% more likely.
Many studies have pointed to a link between private obstetric care and higher rates of caesarean births. But it’s been difficult to tease out the effects of women who may need or want a caesarean birth. We can’t look to the gold standard of evidence in the form of a randomised trial, because it would be unfeasible and unethical to randomly assign women to public and private care.
