Influence Of Two-child Policy On Mode Of Delivery

ObjectiveLess research has been done in the influence of two-child policy on mode of delivery.The article aimed to investigate the rates of cesarean section before and after two-child policy along with indications and complications in order to provide scientific basis and solution for improving the vaginal delivery rate.MethodsRetrospective analysis was conducted on medical record data of 7044 puerperas in Nanjing General Hospital of Nanjing Military Region before(3,526 women from January 1,2012 to December 31,2013)and after(3,518 women from January 1,2015 to December 31,2016)two-child policy.Before the two-child policy there were 3122 primiparas and 404 multiparas,after two-child policy there were 2546 primiparas and 972 multiparas.Comparision was done between two groups in the aspect of vaginal delivery rate,cesarean section rate and the distribution of primiparas in choosing the mode of delivery.Rate of cesarean section for all parturients of the non-medical indications and medical indications.ResultsThe vaginal delivery rate of women before and after the policy was 59.22% and 63.22% respectively,among which the rate of vaginal delivery of primiparas increased dramatically from 60.57% before the policy to 66.10% after the policy(P<0.05).After the two-child policy,the primiparas cesarean section indication with social factors,macrosomia decreased,which was 12.67% vs 5.68%?16.65% vs 11.82%,respectively.However,the rate of cesarean section with in-vitro fertilization increased,which was 5.52% and 10.10% respectively(P<0.05).The rate of caesarean section in our hospital before and after the policy was 73.16% and 78.90% of cesarean section with medical indications.The non-medical indication of cesarean section rate was 21.10% after the policy was lower than 26.84 before the policy.ConclusionAfter two-child policy,the puerperant,especially for the primiparas were more likely to choose vaginal spontaneous delivery.The rate of cesarean section in medical indications increases and the rate of cesarean section decreases with non medical indications.At the same time,the proportion of the primiparas cesarean section also changed.The mode of delivery should depend on corresponding indications properly.