Abstract. The cesarean delivery is a common practice in present scenario in most of the developed as well as many developing countries including India. Cesarean birth has increased noticeably over the last years especially in countries with high or middle income. The present study is based on analysis of data from National Family Health Survey third round in India, which investigate the role of age at marriage and age at first delivery on cesarean cases of first birth. Finding suggests that proposed distribution is appropriate for the age at marriage and first birth of the women, whose first birth is cesarean. Maximum likelihood estimates obtained for the parameters of the distribution. The model suggests the modal age at marriage and first birth in case of first cesarean birth in Uttar Pradesh is 18.41 and 20.56 years.Keywords: Cesarean delivery, age at marriage and first birth, type I extreme value distribution, K-S test.
IntroductionCesarean delivery (here after CD) is a surgical intervention which is carried out to ensure safety of mother and child when vaginal delivery is not possible (emergency CD) or when the doctors consider that the danger to the mother and baby would be greater with a vaginal delivery (planned CD). Proportion of CD to the total births is considered as one of the important indicators of emergency obstetric care. CD was introduced in clinical practice as a life saving procedure both for the mother and the baby which is in under use in low income settings, and adequate or even unnecessary use in middle and high income settings (Althabe and Belizan, 2006). A figure below 5 percent implies that a substantial proportion of women do not have access to surgical obstetric care; on the other hand a rate higher than 15 percent indicates over utilization of the procedure for other than life saving reasons (WHO, 1985). Rapid increase of CD rate throughout the world has emerged as a serious public health issue, also the high rate of CD does not necessarily contribute to an improved maternal health and pregnancy outcome. Birth, a normal human physiological process was once a high mortality event causing both serious maternal and newborn losses. Medical technology and public health measures were introduced to prevent childbirth complications including CD. With the advancement in medical technologies, CD safety has been increasing, leading to a rapid increase in CD rate. But, surgical interventions during pregnancy should be performed to ensure safety of the mother and child under conditions of obstetric risk (Mishra et al. 2002) thus, it is justified under certain circumstances of medical complication and the intervention necessary only in high risk groups, should not be used normally (Bruekens 2001). Morbidity and mortality caused by unnecessary interventions is a serious problem, and worldwide epidemic of obstetrical interventions could have a negative health impact on women and her child. CD should be undertaken only when indicated to enhance the well being of mothers and babies and improves outcom...