Analysis of Caesarean Section Rates and Source of Payment Using the Robson Classification System

Authors

  • Fitasari Nidia Nurhayati Airlangga University
  • Budi Prasetyo Department of Obstetrics and Gynecology, Faculty of Medicine, Airlangga University, Surabaya
  • Muhammad Miftahussurur Gastroentero-Hepatology Division, Department of Internal Medicine, Faculty of Medicine, Airlangga University, Surabaya

DOI:

https://doi.org/10.26911/thejmch.2023.08.01.01

Abstract

Background: Sectio caesarea delivery is the last alternative to save the mother and fetus when normal delivery is not possible. The increase in caesarean section worldwide has become a major public health problem, so it is necessary to supervise to reduce the number of caesarean sections that are considered unnecessary, one of which is through the Robson Classification. The existence of health insurance for the people of Indonesia, including BPJS which covers the costs of sectio caesarea, makes it possible to increase the incidence of sectio caesarea. The aim of the study was to analyze the incidence of sectio caesarea and financing status based on Robson's classification at Muhammadiyah Babat Hospital.

Subjects and Method: This study used a retrospective observational analytic method with a cross sectional design. The research sample was mothers giving birth at Muhammadiyah Babat Hospital who were included in the inclusion criteria and were taken through a total sampling technique of 127 mothers giving birth. The dependent variable is sectio caesarea. The independent variable is financing status. The instrument used was medical record data collected in collection sheets and analyzed using the Chi Square test.

Results: A total of 87 (68.5%) subjects gave birth by sectio caesarea with the prevalence of the Robson group 2, 4, and 5 as the main contributor. A total of 64 (63.4%) subjects gave birth by sectio caesarea with BPJS financing status. The results of the chi-square analysis showed that mothers with BPJS financing status reduced the incidence of sectio caesarea, and it was statistically significant (OR= 0.23; 95% CI= 0.06 to 0.80; p= 0.026).

Conclusion: The data shows that the incidence of sectio caesarea is still very high and most are in the Robson group 1-5 with BPJS financing status. Based on Robson's grouping results, there is a relationship between financing status and the incidence of sectio caesarea, BPJS financing status reduces the incidence of caesarean section.

Keywords: sectio caesarea, robson classification, financing status.

Correspondence: Budi Prasetyo. Department of Obstetrics and Gynecology, Facullty of Medicine, Universitas Airlangga, Indonesia, Jl. Mayjen Pro. Dr. Moestopo No. 47, Pacar Kembang, Tambaksari, Surabaya 60132, East Java, Indonesia. Email: budi-p@fk.unair.ac.id.  Mobile: +6281553019486

References

Alshammari, TM, Subaiea GM, Hussain T, Moin A, Yusuff KB (2018). Parental perceptions, attitudes and acceptance of childhood immunization in Saudi Arabia: A cross sectional study. Vaccine. 36(1): 23–28. doi: 10.1016/j.vaccine.2017..050

Alexander JM, Leveno KJ, Hauth J, Landon MB, Thom E, Spong CY, et al. (2006) Fetal injury associated with cesarean delivery. Obstetrics & Gynecology. 108 (4): 886-887. doi: 10.1097/01.AOG.0000237116.72011.f3

Boyle A, Uma MR, Helain JL, Chunchih H, Rita WD, Katherine L (2018). Primary cesarean delivery in the United States. Obstetrics & Gynecology. 122(1): 33–40. doi: 10.1097/AOG.0b013e3182952242.

BPJS Kesehatan (2018). Laporan pengelolaan program dan laporan keuangan jaminan sosial kesehatan tahun 2018 (2018 health social security program management report and financial report). Jakarta: BPJS Kesehatan.

Operasi caesar masalah dan solusinya (Caesarean section problems and solutions). Jakarta: Pustaka Pembangunan Swadaya Nusantara.

Cunningham, Leveno, Bloom, Dashe, Hoffman, Casey, Spong (2018). Williams Obstetric. Twenty-five Edition. Mc-Graw-Hill Global Education Holdings.

Donnez O, Donnez J, Orellana R, Dolmans M (2017). Gynecological and obstetrical outcomes after laparoscopic repair of a cesarean scar defect in a series of 38 women. Fertility and Sterility. 107(1): 289–296. doi: 10.1016/j.fertnstert.2016.09.033.

Gautam B, Acharya S, Sapkota V, Batsal R, Bhattrai L, Jose M, et al. (2020). Cesarean section rate at Lumbini Zonal Hospital, Nepal: An analysis using the Robson Ten Group cla-ssification system. Obstetrics & Gynecology. 7(1): 9-14. doi: 10.17140/GOROJ7154.

Jadoon B, Tamer MA, Amany AR, Heba EA, Ahmed SA, Wagdy MA (2020). Analysis of the caesarean section rate using the 10-Group Robson classifycation at Benha University Hospital, Egypt. Women and Birth: journal of the Australian College of Midwives. 33(2): e105–e110. doi: 10.1016/j.wombi.2019.03.009.

Joewono HT, Sulistyono A, Anny Kartiningsih NK, Aditiawarman (2020). Birth outcomes of maternal morbid obesity. Systematic Reviews in Pharmacy. 11(3): 868-873. doi: https://doi.org/10.31838/srp.2020.3.127.

Kementerian Kesehatan Republik Indonesia (2018). Laporan nasional riset kesehatan dasar 2018 (report of Indonesian basic health survey 2018). Jakarta: Badan Litbang Kesehatan.

Kurniawati EM, Irwanto S, Muhdi N (2021). The sexual function of primiparous women after normal delivery and cesarean section according to the female sexual function index. Journal of Medical Sciences. 9(3): 1237-1240. doi: https://doi.org/10.3889/oamjms.2021.6139.

Manuaba I (2009). Patologi obstetri (Obstetric pathology). Jakarta: EGC.

Marlina (2016). Faktor persalinan sectio caesarea di rumah sakit imanuel Bandar Lampung (Factors of sectio caesarea delivery at Immanuel Hospital in Bandar Lampung). Jurnal Kesehatan. 7(1): 57-65. doi: 10.26630/jk.v7i1.119.

Nilsson C, Lalor J, Begley C, Carroll M, Gross M, Grylka-Baeschlin S, Lundgren, et al. (2017). Vaginal birth after caesarean: views of women from countries with low VBAC rates. Women and Birth: journal of the Australian College of Midwives. 30(6): 481–490. doi: 10.1016/j.wombi.2017.04.009.

Nugroho, T (2010). Buku ajar obstetri (Textbook of Obstetrics). Yogyakarta: Nuha Medika.

Prawirohardjo (2015) Ilmu Kebidanan (Obstetrics). Jakarta: Yayasan Bina Sarwono Prawirohardjo.

Robson MS (2001). Can we reduce the caesarean section rate?. Best Practice and Research: Clinical Obstetrics and Gynaecology. 15(1): 179–194. doi: 10.1053/beog.2000.0156.

Sumelung (2019). Faktor-faktor yang berperan meningkatnya angka kejadian sectio caesarea di rumah sakit umum daerah Liun Kendage Tahuna (Factors contributing to the increase in the incidence of sectio caesarea at the Liun Kendage Tahuna general hospital). Journal keperawatan. 2(1): 1-7. doi: 10.35790/jkp.v2i1.4052.

Sihombing NM, Saptarini I, Putri (2017). Determinan persalinan sectio caesarea di Indonesia (analisis lanjut data riskesdas 2013) (Determinants of caesarean section delivery in Indonesia (advanced analysis of 2013 Riskesdas data)). Jurnal Kesehatan Reproduksi. 8(1): 63–73. doi: 10.22435/kespro.v8i1.6641.63-75.

Wiklund I, Edman G, Andolf E (2007). Cesarean section on maternal request: reasons for the request, self-estimated health, expectations, experience of birth and signs of depression among first-time mothers. Acta Obstetricia et Gynecologica Scandinavica. 86(4): 451–456. doi: 10.1080/00016340701217913.

Wiknjosastro H (2007). Ilmu Kebidanan (Obstetrics). Jakarta: Yayasan Bina Pustaka Sarwono Prawirohardjo.

World Health Organization (2017). Robson classification: implementation manual. Retrived from: https://www.who.int/publications/i/item/9789241513197.

World Health Organization (2021). Caesarean section rates continue to rise, amid growing inequalities in access. Retrieved from: https://www.who.int/news/item/16-06-2021-caesarean-section-rates-continue-to-rise-amid-growing-inequalities-in-access.

Downloads

Published

2023-01-16

How to Cite

Nurhayati, F. N., Prasetyo, B., & Miftahussurur, M. (2023). Analysis of Caesarean Section Rates and Source of Payment Using the Robson Classification System. Journal of Maternal and Child Health, 8(1), 1–11. https://doi.org/10.26911/thejmch.2023.08.01.01

Issue

Section

Articles