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VOLUME 45 | NUMBER 5 | OCTOBER 2010


Declining Fertility and the Use of Cesarean Delivery: Evidence from a Population-Based Study in Taiwan

Keywords:
Fertility;cesarean delivery;physician-induced demand;multinomial probit model;Taiwan
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.

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