INVESTIGATING THE FREQUENCY OF NORMAL VAGINAL DELIVERY AND CESAREAN SECTION AND CAUSES OF CESAREAN SECTION IN PUBLIC AND PRIVATE CENTERS AND COMPARING IT WITH EDUCATIONAL CENTERS IN ZAHEDAN

Abstract

Introduction. Cesarean section plays an important role in decreasing the mortality and complications of childbirth in the mother and fetus. But the worrying issue in modern midwifery is the high rate of cesarean section. The current study was done to evaluate the frequency of normal vaginal delivery and cesarean section and the causes of cesarean section in public-private centers and compare it with educational centers in Zahedan in 2016-2017. Materials and methods. This is a descriptive cross-sectional study and a total of 792 deliveries were studied, 300 cases were from university hospitals and 492 from non-university hospitals in Zahedan. SPSS22 software was used for data analysis. Findings. The results disclosed that in university hospitals, 65.3 of the deliveries were normal vaginal delivery and 34.7 were cesarean, and in the non-university hospitals, 44.5 and 55.5 of the deliveries were normal and cesarean deliveries, respectively. There was a significant relationship between the type of delivery and the hospital where the delivery was done (P < 0.001). The most common causes of cesarean section in this study were: previous cesarean section (33.7), fetal distress (14.9), cesarean delivery on maternal request (CDMR) (11.7), delivery failure (11.4), mother's disease (7.4), abnormal fetal placement (6.6), multiparous pregnancy (4.5), problems with the placenta and umbilical cord (4), cephalopelvic disproportion (3.2) and embryonic diseases (2.7). There was no cesarean delivery on maternal request (CDMR) in university hospitals while in non-university hospitals it was 16.1. Conclusion. Generally, the percentage of normal vaginal delivery was higher than that of the cesarean section, but the number of cesarean sections was higher in non-university hospitals than in university hospitals. Also, ethnicity, number of pregnancy, job, education, history of infertility, and awareness of complications were significantly related to the type of delivery.