# Changes in proportions of Cesarean section before and during the COVID‐19 pandemic in Japan

## TL;DR

The study found that the rate of Cesarean sections in Japan increased during the COVID-19 pandemic, likely due to infection control measures.

## Contribution

This study quantifies the increase in Cesarean section rates in Japan during the pandemic, providing new empirical evidence on its impact on childbirth practices.

## Key findings

- The proportion of Cesarean sections increased from 20.27% before the pandemic to 21.19% during the pandemic.
- The highest Cesarean section rate was observed in Wave 6 (22.14%), followed by a slight decrease in Wave 7.
- The overall increase of 0.92 percentage points is attributed in part to infection control measures.

## Abstract

After the coronavirus disease 2019 (COVID‐19) pandemic, Cesarean sections for COVID‐19‐positive cases were performed to reduce delivery time and thus control infection. This may have increased the proportion of Cesarean sections and affected many pregnant women in Japan; though this expected trend has not yet been quantified. This study examined changes in the proportions of Cesarean sections in Japan before and during the pandemic.

This study retrospective observational study used the National Database of Health Insurance Claims and Specific Health Checkups of Japan and Vital Statistics from the National Statistical Surveys from April 2018 to October 2022. We compared proportions of Cesarean sections (total Cesarean sections/total live births) in Japan before and during the pandemic and by the COVID‐19 pandemic phase: pre‐COVID‐19 (April 2018 to December 2019), Wave 1 (January to May 2020), Wave 2 (June to October 2020), Wave 3 (November 2020 to February 2021), Wave 4 (March to June 2021), Wave 5 (July to December 2021), Wave 6 (January to June 2022), and Wave 7 (July to October 2022).

The proportion of Cesarean sections in Japan was 20.27% (317 241/1 564 912) before the pandemic and increased to 21.19% (486 172/2 294 488) during the pandemic. The highest proportion was in Wave 6 (22.14%), dropping to 21.27% in Wave 7.

The overall proportion of Cesarean sections increased by 0.92% point during the COVID‐19 pandemic in Japan, possibly due in part to infection control measures. Verification and preparation are necessary to respond to future pandemics.