Rising trend of caesarean section in primigravida at Lady Aitchison Hospital Lahore: Phenomenological analysis of indications

Abstract

Objective: To highlight the rising trend of caesarean section and strategies to reduce the caesarean section rate in an urban setting. Methods: The qualitative, phenomenological study was conducted at the Lady Aitchison Hospital, Lahore, Pakistan, from October 16 to November 30, 2020, and comprised obstetrics and gynaecology practitioners principally responsible for making decisions related to caesarean sections. Data was collected through face-to-face detailed interview with each subject. The interviews were transcribed manually and codes were formed that led to themes. Results: Of the 10 subjects interviewed, 1(10%) was the department head, 2(20%) were associate professors, 2(20%) were assistant professors and 5(50%) were senior registrars. Main indications of caesarean section in primigravida were foetal distress, failed induction, failure to progress, social demand, malpresentation, eclampsia and antepartum haemorrhage. There were 5-7 themes that fell under each of these seven codes. Conclusion: With proper implementation of uniform decision-making strategies, the rate of caesarean section in primigravida can be lowered with proper antenatal assessment, cardiotocographic monitoring, obstetric skills teaching, specialists; involvement in decision making and counselling of patients. Key Words: Caesarean section, Primigravida, Phenomenology, Analysis.

A Review of Cesarean Section Rates and Associated Factors in Pakistan Using Anderson Health Behavior Model

“…Similar results have been seen in Pakistan, where women have shown to prefer caesarean section, because of the fear of birth trauma to the newborn, labour pain, or complications of vaginal delivery such as possible fecal or urinary incontinence [35,36]. Another study conducted in Pakistan shows that the intensity of fear of childbirth calculated by W-DEQ amongst pregnant women in the third trimester of pregnancy was relatively high, with a much higher rate of CS in women who have this fear [37]. Dissatisfaction with childbirth is well-documented for cesarean delivery, which can cause postpartum maternal depression and a lesser caretaking approach with their babies within the first five months [38], however such evidence is not readily available in Pakistan.…”