The aim of this study was to investigate the association between patients' and prenatal care characteristics and cesarean section prevalence. A cross-sectional study including structural and process-of-care variables was conducted at primary health care facilities in Pelotas, Brazil. All health centers were selected and 712 mothers were interviewed. The observed cesarean rate was 30.0%. Adjusted analyses showed that cesareans were associated with maternal characteristics (short stature, few pregnancies, planned pregnancy, hospitalization, and high blood pressure). Among health services variables, the study detected a direct protective effect of time since graduation by the physician providing the prenatal care and compliance with Prenatal Care Program guidelines. Higher cesarean section rates were observed at university hospitals. To reduce the cesarean section rate, maternal education during pregnancy, early diagnosis, and proper management of hypertension and causes of hospitalization are possible strategies for approaching the problem in the primary health care sector.
Prenatal Care; Health Services; Primary Health Care
