Socioeconomic inequalities in health
Delaying fertility in Czech women brings complications. As women get older, the length of hospitalisation after childbirth gradually increases. The highest chances of long hospitalisation times are for women over 40 years old, who are twice as likely to have a long hospitalisation after childbirth than women aged 30-34, said Anna Šťastná, a researcher at the National Institute of SYRI and the Charles University. In a detailed study, the researchers looked at the relationship between a woman's age and the length of her hospital stay. One of the reasons for this is that the Czech Republic is one of the countries with the longest postpartum hospitalisation time.
"The postponement of childbearing to a higher age, and thus the significant change in the age structure of Czech mothers, is accompanied by a number of other age-related factors, such as a significant increase in the number and proportion of births by caesarean section, the use of assisted reproductive technologies and an increase in the proportion of multiple births," Šťastná points out.
For the analysis, the researchers used anonymised data from the General Health Insurance Company on all here-insured mothers who gave birth in inpatient health care facilities in 2014. The final analytical file contains data on 50.4 thousand women, which represents 47.1% of all women who gave birth in the Czech Republic in 2014. "The question of whether the age of the women giving birth can itself be related to the risk of long hospitalisation is also interesting from the point of view that the Czech Republic has long been one of the countries with the longest postpartum hospitalisation times among OECD countries," says Šťastná.
In addition to older women, the risk of long hospital stays also affects the youngest women. While mothers under the age of 19 are 1.6 times more likely to have a long hospital stay than mothers aged 30-34, this chance decreases to 1.3 times for women aged 20-24 and 1.15 times for women aged 25-29 compared to the 30-34 age group. "In women over 35 years of age, the chances of a long hospital stay increase to 1.23 times. The highest chances of a long hospital stay are for women over 40 years of age, who are twice as likely to have a long hospital stay after childbirth compared to women aged 30-34 years," mentions Šťastná.
The results show that the most common hospital stay associated with childbirth in 2014 was five days for vaginal deliveries (42%) and six days for cesarean deliveries (31%). The average length of hospitalisation due to childbirth was 5.5 days for vaginal births and 7.5 days for caesarean births. Three quarters of women were hospitalized for a maximum of 6 days for vaginal births and 8 days for caesarean deliveries.
"In our analysis, then, long hospitalisation included hospitalisation related to childbirth of 7 or more days in the case of vaginal delivery and 9 or more days in the case of caesarean delivery. The risk of long hospitalization in the youngest mothers is higher for both types of delivery, but more pronounced in the case of cesarean delivery. On the other hand, after the age of 35, there is an increase in the risk of long hospitalisation in the case of vaginal deliveries, which increases significantly after the age of 40," adds Šťastná.
See more: Does advanced maternal age explain the longer hospitalisation of mothers after childbirth? | PLOS ONE