Abstract
BackgroundCaesarean section is considered a relatively preferable and safe method of delivery as compared to normal delivery. Since the last decade, its prevalence has increased in both developed and developing countries. In the context of developing countries viz., South Asia (the highest populated region) and South-East Asia (the third-highest populated region), where a significant proportion of home deliveries were reported,however, the preference for, caesarean delivery and its associated factors are not well understood.ObjectiveTo study the caesarean delivery in the South and South-East Asian countries and to determine the factors associated with the preference for caesarean delivery.MethodologyDemographic and Health Survey Data on from ever-married women of nine developing countries of South and South-East Asia viz., Vietnam, India, Maldives, Timor-Leste, Nepal, Indonesia, Pakistan, Bangladesh, and Cambodia have been considered. Both bivariate and binary logistic regression models were used to estimate the propensity of a woman undergoing for caesarean delivery and to assess the influence of maternal socioeconomic characteristics towards the preference for caesarean delivery.ResultsObtained results have shown an inclination of caesarean delivery among urban than rural women and are quite conspicuous, but is found to be underestimated mostly among rural women. Caesarean delivery in general is mostly predisposed among women whose baby sizes are either very large or smaller than average, have a higher level of education and place of delivery is private medical institutions. The logistic regression also revealed the influence of maternal socioeconomic characteristics towards the preference for caesarean delivery. Based on nine South and South-East Asian countries an overall C-section prevalence of 13%, but based on institutional births its increase to 19%. The forest plot demonstrated that a significant inclination of C-section among urban than rural regions. In Meta-Analysis, very high and significant heterogeneity among countries is observed, but confirms that in terms of prevalence of C-section all of the countries follow independent pattern.ConclusionStudy of seven urban and four rural regions of nine South and South- East Asian countries showed, a significant inclination towards the caesarean delivery above the more recent outdated WHO recommended an optimal range of 10–15%and are associated maternal socioeconomic characteristics. In order to control unwanted caesarean delivery, the government needs to develop better healthcare infrastructure and along with more antenatal care related schemes to reduce the risks associated with increased caesarean delivery.
Highlights
Caesarean section in developed and developing countries[1,2,3], are considered as the mostpreferred method of childbirth
In order to control unwanted caesarean delivery, the government needs to develop better healthcare infrastructure and along with more antenatal care related schemes to reduce the risks associated with increased caesarean delivery
This study examines the prevalence of caesarean section in selected countries of South and South-East Asia, which is the top and third-largest populous region in the world
Summary
Caesarean section in developed and developing countries[1,2,3], are considered as the mostpreferred method of childbirth. In most of the developing countries, demographic changes, social and educational improvement have led to an increase in the number of women delaying their pregnancies until getting on their end of fertile life[7]. The Caesarean section or C-section is a surgical procedure, where delivery proceeds through the abdominal and uterine incision This procedure is appropriate in situations where vaginal (or normal) delivery is considered life-threatening for the mother and the baby. Earlier works[16,17,18] have suggested that if caesarean rate increases above WHO recommended the range, as a consequence the risk of manifestation of other public health-related problems for both mothers and children will increase. Caesarean section is considered a relatively preferable and safe method of delivery as compared to normal delivery. In the context of developing countries viz., South Asia (the highest populated region) and South-East Asia (the third-highest populated region), where a significant proportion of home deliveries were reported,the preference for, caesarean delivery and its associated factors are not well understood
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