Public and social environment changes and caesarean section delivery choice in Japan

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7 Citations (Scopus)


Objective: As in many other countries, the ratio of caesarean section (c-section) delivery to total births in Japan is rising steadily, while the total number of deliveries is decreasing. Although c-sections can effectively prevent maternal and perinatal mortality and morbidity when medically justified, it is uncertain how medically unnecessary c-sections affect the short-, middle-, and long-term postnatal effects on the mother and child. As there are no empirical studies on c-section choice for Japan, this study uses individual medical facility panel data from 1999 to 2014 to comprehensively examine the effects of recent public and social environment changes on c-section delivery choice. Results: The empirical results from our fixed effect model show that c-section delivery and its ratio are higher in public hospitals, in relatively large clinics, and in clinics opening on holidays. In addition, increases in the lump-sum birth allowance and the number of medical malpractice lawsuits also increase the number of c-section delivery.

Original languageEnglish
Article number633
JournalBMC Research Notes
Issue number1
Publication statusPublished - 2018 Sept 3


  • Agency problem
  • Cesarean section delivery
  • Defensive medicine
  • Japan
  • Panel data


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