Migration and Caesarean section birth in the United Kingdom: a secondary analysis of Born in Bradford data

Background

Caesarean section (C-section) rates in the United Kingdom continue to increase and are a concern. Births to migrants account for 30.3% of live births in England and Wales. Other international studies have observed varying rates of C-section for migrant populations in comparison to women born within the country itself. Comparison of incidence rates of Caesarean section birth between migrant populations and women born in the United Kingdom (UK) was undertaken to inform the UK context and address an existing dearth of data.

Methods

This study included analysis of 11,361 records from the Born in Bradford cohort study. Binomial logistic regression analysis was performed to estimate crude and adjusted odd ratios (aOR) with 95% confidence intervals (CI) for the incidence of total, elective, and emergency C-section births between migrant populations and UK-born women.

Results

Women from “South Asia” and “Central Europe, Eastern Europe, and Central Asia” demonstrate lower incidences of total C-section with a significantly lower elective C-section. Women from Sub-Saharan Africa demonstrate significantly high rates of total C-section (38% increased odds).

Discussion

High variation in the incidence of C-section amongst migrant populations was observed, replicating findings from the few other international studies. Further in-depth exploration is required to understand the impact of this variation on maternal and neonatal health disparities, and to assess the contribution of potential pathophysiological and sociocultural factors on related decision-making processes.