Abstract
BackgroundCaesarean section (CS) delivery has a significant effect on maternal and neonatal health especially in a developing country like Bangladesh. The aim of the study was to determine the risk factors and their individual contribution to CS delivery among Bangladeshi married women in reproductive age.MethodsThe cross sectional secondary data was used in this study. Data was extracted from Bangladesh Demographic and Health Survey (BDHS), 2014 dataset. BDHS-2014 collected data from all over Bangladesh. Stepwise logistic regression analysis and population attributable fractions (PAF) were utilized in this study.ResultsA total number of 4422 married Bangladeshi women having at least one child (age ≤ 5 years) were considered in this study. The prevalence of CS delivery among Bangladeshi women was 23.94%. The stepwise logistic regression model showed that location (division), type of residence, education of respondent and her husband, working status, age at first birth, number of children, wealth index and baby’s birth weight were most important predictors of CS delivery among Bangladeshi mothers. PAF demonstrated that overweight or obese women had highest contribution (23.36%) among the risk factors of CS delivery, followed by age at first birth (age > 20 years) (18.97%), highest wealth quintile (17.39%), higher education (15.93%), living in urban environment (14.39%), having lower number of ever born children (1–2 children) (13.58%), living in Dhaka division (12.11%), delivering large size of child at birth (11.13%) and housewife (6.55%).ConclusionsIn the present study, we have identified the important risk factors and their individual contribution to CS delivery in Bangladesh. Consequently, these factors can be considered for reducing the rate of CS delivery in Bangladesh.
Highlights
When vaginal delivery is not possible, caesarean section (CS) is an alternative mode of giving birth, which ensures the safety of mother and her child
In 1985 World Health Organization (WHO) suggested that the optimal population range for Caesarean section (CS) delivery rates would be between 5 and 15% [3, 4], and WHO stated, in 2015 (BMG-2016) that for the crying need of CS delivery to a woman all possible effort should be provided without endeavoring any kind of specific rate [5]
It was noted that the highest number of CS delivery was found in Khulna (35.5%) division followed by Dhaka (32.9%), Rajshahi (27.7%), Chittagong and Barisal (20.1%), Rangpur (19.3%) and Sylhet (12.8%) divisions. χ2-test demonstrated that the association between living location and mode of birth was statistically significant (p < 0.001)
Summary
When vaginal delivery is not possible, caesarean section (CS) is an alternative mode of giving birth, which ensures the safety of mother and her child. CS delivery is a highly effective procedure with surgical intervention in obstetrical care for preventing birth complications of a mother. CS delivery causes various complications for mother and the birth could be traumatic for the baby with long term consequences. During pregnancy maternal deaths are mainly caused by hemorrhage, unsafe abortion, hypertension, obstructed labour and infections. Though these types of complications are unpredictable, almost all could be prevented by ensuring institutional delivery services as timely management and treatment can make the difference between life and death [6, 7]. The aim of the study was to determine the risk factors and their individual contribution to CS delivery among Bangladeshi married women in reproductive age
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