To test the hypothesis that declining fertility would affect the number of cesarean sections (c‐sections) on maternal demand, but not medically indicated c‐sections.
The 1996–2004 National Health Insurance Research Database in Taiwan for all singleton deliveries.
Retrospective population‐based, longitudinal study. Estimation was performed using multinomial probit models.
Results revealed that declining fertility had a significant positive effect on the probability of having a c‐section on maternal request but not medically indicated c‐section.
Our findings offer a precautionary note to countries experiencing a fertility decline. Policies to contain the rise of c‐sections should understand the role of women's preferences, especially regarding cesarean deliveries on maternal request.
