Abstract
Caesarean section (CS) can prevent maternal and neonatal mortality and morbidity. However, it involves risks and high costs that can be a burden, especially in low and middle income countries. The aim of this study is to assess its magnitude and correlates among women of reproductive age in the urban and rural areas of Vietnam. We analyzed microdata from the national Multiple Indicator Cluster Survey (MICS) conducted in 2014 by using a representative sample of households at the national level in both urban and rural areas. A total of 1,350 women who delivered in institutional settings in the two years preceding the survey were included. Frequency and percentage distributions of the variables were performed. Bivariate and multivariate logistic regression analyses were undertaken to identify the factors associated with CS. Odds ratios with a 95% confidence interval were used to ascertain the direction and strength of the associations. The overall CS rate among the women who delivered in healthcare facilities in Vietnam has rapidly increased and reached a high level (29.2%). After controlling for significant characteristics, living in urban areas doubles the likelihood of undergoing a CS (OR = 1.98; 95% CI 1.48 to 2.67). Maternal age at delivery over 35 years is a major positive correlate of CS. Beyond this common phenomenon, different distinct lines of socioeconomic and demographic cleavage operate in urban compared with rural areas. The differences regarding the correlates of CS according to the place of residence suggest that specific measures should be taken in each setting to allow women to access childbirth services that are appropriate to their needs.
Highlights
Caesarean section (CS) can prevent maternal and neonatal mortality and morbidity when medically justified
The overall CS rate among the women who delivered in healthcare facilities in Vietnam in 2014 was high (29.2%) compared with many low- and middle-income countries [5] [6]
Our study reveals that a maternal age of over 35 years at childbirth more than doubles the likelihood of undergoing a CS and that this effect is stronger in urban areas, where childbearing is experienced slightly later than in rural areas
Summary
Caesarean section (CS) can prevent maternal and neonatal mortality and morbidity when medically justified. Urbanization is related to a population that moves from a rural to an urban area and an increased concentration of people who live in urban areas and to the entire process of societal adaptation to the subsequent changes, and urbanization has been identified as a prominent contributing factor to CS practices in several countries and areas [5] [6] [7] [8] [9] [10] [11]. This influence is controversial [12] [13] [14]
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