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Prepartum Work, Job Characteristics, and Risk of Cesarean Delivery

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Background: Reducing the rate of cesarean deliveries in the United States is a high priority among public health officials and members of the medical community. Many factors known to contribute to an individual woman's risk of having a cesarean rather than a vaginal delivery are not readily altered by public policy intervention. In this study we explored the effects on type of delivery of prepartum work practices, a category of factors that has a potential to affect the likelihood of cesarean delivery and to be amenable to change. Methods: Data are from U.S. Food and Drug Administration's Infant Feeding Practices Study, using questions on mail surveys administered prenatally and at 1 month postpartum. The sample comprised 1194 women who worked during pregnancy. The outcome measure is type of delivery. Predictor variables are characteristics of prepartum work: how far into their pregnancy the women work, number of hours worked, and occupation. Results: For most women, maintaining employment through the third trimester, working long hours, and working in certain occupations are not independently associated with the odds of having a cesarean delivery. However, we found marginally significant evidence that those women who worked more than 40 hours a week in a sales job were more likely to have cesarean deliveries than women who worked in other occupations. Conversely, women working part-time in sales jobs were less likely to have a cesarean delivery. Conclusion: This study provides evidence that prenatal work does not substantially increase the probability of having a cesarean delivery in most occupational categories. (BIRTH 29:1 March 2002)

Document Type: Research Article


Affiliations: 1: Shirley Hung is from Cable News Network, Washington, DC. 2: Donna Morrison and Leslie Whittington are from the Georgetown Public Policy Institute, Georgetown University, Washington, DC. 3: Sarah Fein is from Division of Market Studies, Food and Drug Administration, U.S. Department of Health and Human Services, College Park, Maryland.

Publication date: March 1, 2002


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