Vaginal or Caesarean Delivery? A Comparative Study of Factors Associated with the Choice Method of Childbirth Delivery in Kenya and Egypt

Abstract

Background: Childbirth delivery today is becoming a complex process. There exist linkages between choice method of childbirth delivery, whether vaginal or caesarean section, and socioeconomic, maternal, and pregnancy-related factors.
 Study objectives: To compare the choice method of childbirth delivery among women of childbearing ages in Kenya and Egypt. Specifically, the study sought to (a) show patterns of caesarean section births in the two countries using women’s background characteristics, (b) estimate levels and differentials of caesarean births in the two countries and, (c) investigate the socio-economic, maternal and pregnancy-related factors that determine the choice of caesarean section deliveries in the two countries
 Data and methods: Data was derived from the 2014 Kenya and Egypt demographic and health surveys women-file. The data was fitted in the Statistical Package for Social Sciences in which descriptive and binary logistic regression analyses were conducted.
 Results: Majority of Egyptian women (53.5%) gave birth by caesarean section compared to Kenyan women (7.8%). At descriptive analysis level, all the study variables were significant at ρ<0.05 and less, save for marital status. At inferential level, there were higher odds of caesarean section delivery among Egyptian women in middle and rich households (1.318 and 1.701, respectively) compared to those from poor households. Among Kenyan women, those aged 25-34 and 35-49 were 1.335 and 1.690 more likely to delivery by caesarean section compared to their colleagues in the 15-24 age group. Pertaining to the number of antenatal care visits, Egyptian women who had no antenatal care visits were 0.761 less likely, while those with 5-8 and at least 9 antenatal care visits were 1.296 and 1.783, respectively, more likely to delivery by caesarean section compared to their colleagues with 3-4 antenatal care visits. Such a trend was observed among Kenyan women for 5-8 and 9+ antenatal care visits, at the odds of 1.234 and 2.053 respectively. Childbirth deliveries in private health facilities had the odds of 2.060 and 1.438 in Egypt and Kenya, respectively, compared to delivery in public health facilities.
 Conclusion: The results suggest that the main contributory factors behind the choice method of childbirth delivery are household wealth (Egypt), maternal age (Kenya), number of antenatal care visits (both Kenya and Egypt), and place of delivery (both Kenya and Egypt).