Determinants of caesarean section in Bangladesh: Cross-sectional analysis of Bangladesh Demographic and Health Survey 2014 Data

Abstract

BackgroundCaesarean section (CS) has been on the rise worldwide and Bangladesh is no exception. In Bangladesh, the CS rate, which includes both institutional and community-based deliveries, has increased from about 3% in 2000 to about 24% in 2014. This study examines the association of reported complications around delivery and socio-demographic, healthcare and spatial characteristics of mothers with CS, using data from the latest Bangladesh Demographic and Health Survey (BDHS).MethodsThe study is based on data from the 2014 BDHS. BDHS is a nationally representative survey which is conducted periodically and 2014 is the latest of the BDHS conducted. Data collected from 4,627 mothers who gave birth in health care institutions in three years preceding the survey were used in this study.ResultsAverage age of the mothers was 24.6 years, while their average years of schooling were 3.2. Factors like mother being older, obese, residing in urban areas, first birth, maternal perception of large newborn size, husband being a professional, had higher number of antenatal care (ANC) visits, seeking ANC from private providers, and delivering in a private facility were statistically associated with higher rates of CS.ConclusionsBangladesh health system urgently needs policy guideline with monitoring of clinical indications of CS deliveries to avoid unnecessary CS. Strict adherence to this guideline, along with enhance knowledge on the unsafe nature of the unnecessary CS can achieve increased institutional normal delivery in future; otherwise, an emergency procedure may end up being a lucrative practice.

Opting for home birth in rural Bangladesh: An assessment of the current status and reasons

“…32 It could also reflect the lack of compensation for wage loss of women when seeking facility birth. [33][34][35][36] Our findings suggest that there is some level of discomfort and fear around cesarean section in Brahmanbaria, and this may be one of the important reasons why women are opting to give birth at home. Concern over the possibility of cesarean section can be another explanation, as women can incur additional costs when the procedure is performed.…”

“…5 Although cesarean section can be an important surgical intervention for certain obstetric complications, such a high rate may pose more harm than benefit. [33][34][35][36] Our findings suggest that there is some level of discomfort and fear around cesarean section in Brahmanbaria, and this may be one of the important reasons why women are opting to give birth at home. Considering the immediate and long-term health consequences for women of unnecessary cesarean sections and the additional financial burden that they impose on families and health systems, appropriate policies and actions are required to impose better accountability and avoid unnecessary use of cesarean sections in health facilities.…”

Risk Factors for Wound Infection Following Caesarean Section: A Case Control Study from Sir Salimullah Medical College & Mitford Hospital in Dhaka, Bangladesh

“…The incidence of CS has dramatically increased in Bangladesh [2]. With this increase, increased risk of infections and long-term morbidity and mortality have become concerns.…”

“…An analysis of health and demographic surveys of seventy-two low and middle income countries (LMICs) conducted between 2010 and 2014 showed national CS rates ranging from 0.6% in South Sudan to 58.9% in the Dominican Republic [1]. In Bangladesh, the CS rate increased from 3% in 2000 to 24% in 2014 [2]. CS is associated with an increased risk of maternal mortality.…”

Too Posh to Push: Determinants of Planned C-Section Delivery Among Indonesian Women

“…As for the potential explanatory variables, we selected them based on previous literature [11,[17][18][19][20][21][22][23][24][25][26][27]. We categorized them into several groups, namely spatial variables, maternal variables, demographic variables, access to information, and socio-economic variables.…”