Patient‐Initiated Elective Cesarean Section of Nulliparous Women in British Columbia, Canada
Bibliographic record
Abstract
BACKGROUND: The proportion of cesarean sections is increasing in Canada overall and in British Columbia in particular. It has been suggested that this increase is partially the result of women requesting the procedure, although the prevalence of patient-initiated elective cesarean section is unclear. The objective of this study was to examine the prevalence of probable elective cesarean and physician-suggested elective cesarean section among nulliparous women who had a cesarean section in British Columbia, Canada. METHODS: An electronic search of patient charts from seven British Columbia hospitals between June 1, 2002, and May 31, 2004, was completed and potential nulliparous women seeking elective cesarean were identified. Any women with medical factors predisposing them to a cesarean section were excluded. Identified charts were then subjected to individual chart review by two independent researchers to ensure accuracy of classification into a cohort of women with probable patient-initiated elective cesarean section. RESULTS: For the study period, 10,546 nulliparous women gave birth at the seven study hospitals and 3,301 delivered by means of cesarean section. Of these 3,301 women, 36 were judged to have had a patient-initiated elective cesarean. These 36 women represented 0.34 percent of all nulliparous births and 1.09 percent of all nulliparous cesarean births. Those judged to have selected an elective cesarean were significantly older and had babies with a lower gestational age than women with a nonelective cesarean section. No significant differences between the two groups were found with respect to maternal weight, length of stay for the mother or baby, newborn birthweight, or special care nursery days. CONCLUSIONS: Overall, the prevalence of nulliparous women judged to have had a patient-initiated elective cesarean was found to be low and is not likely to be substantially contributing to the rising proportion of cesarean births.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".