The Prevalence and Associated Factors of Caesarean Section at Noakhali Sadar, Bangladesh

Background: The present Caesarean section (C-Section) delivery rate is 33% in Bangladesh which is almost double what is recommended by the World Health Organization for each country. C-section delivery is related to surgical complications, thus increase the rate of hospitalization and reduce women’s quality of life. However, data on C-section delivery rates in different areas in this country are limited. Keeping this in mind, the objective of this study was to investigate the prevalence and factors associated with C-section deliveries in Noakhali district, Bangladesh.

Methods: A cross-sectional study was carried out among 400 women of child-bearing age from Noakhali district, Bangladesh, who had either cesarean (215) or normal vaginal delivery (185) in the last two years using a structured questionnaire. Data were analyzed using SPSS version 26.0 and frequency tabulation, binary and multivariate logistic regression analyses were performed to achieve the study objective.

Results: The prevalence of C-Section in the study area was 53.75%, which was higher than the current Bangladeshi C-section prevalence rate. The most important predictors of C-section delivery among the study area were the mother’s nutritional status, education of the respondent and her husband, family income, normal representation of the fetus, prolong labor pain during delivery, delivery in a private facility, term delivery, and baby’s birth weight. The adjusted odds of undergoing C-section was higher among respondents who were overweight (AOR=6.53; CI=3.007 to 14.18), had LBW baby (AOR= 4.641; CI=2.066 to 10.42), family income more than or equal 20,000 (AOR =3.038; CI=1.056 to 8.743),prolong labor pain during delivery (AOR = 6.027; CI=2.829 to 12.84), performed delivery in private facility (AOR= 27.88; CI=11.55 to 67.33) and mal-presentation of the fetus (AOR = 6.867; CI=2.519 to 18.72).

Conclusions: The health care system in Noakhali and other districts in Bangladesh urgently needs policy guidelines to monitor C-Section delivery indications to avoid high rates of unnecessary C-Section.