Predictors of elective and emergency caesarean deliveries in India: evidence from large scale survey

Gudakesh Yadav; Koustav Ghosh; Prashant Shekhar; Shrey Pandya

doi:10.18203/2394-6040.ijcmph20260316

Authors

Gudakesh Yadav Population Research Centre (PRC Baroda), Department of Statistics, The Maharaja Sayajirao University of Baroda, Vadodara-390002, Gujarat, India
Koustav Ghosh Population Research Centre (PRC Baroda), Department of Statistics, The Maharaja Sayajirao University of Baroda, Vadodara-390002, Gujarat, India https://orcid.org/0000-0002-7085-1885
Prashant Shekhar Population Research Centre (PRC Baroda), Department of Statistics, The Maharaja Sayajirao University of Baroda, Vadodara-390002, Gujarat, India
Shrey Pandya Population Research Centre (PRC Baroda), Department of Statistics, The Maharaja Sayajirao University of Baroda, Vadodara-390002, Gujarat, India

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20260316

Keywords:

ANC visits, Determinants, Elective C-sections, Emergency C-sections, Prevalence

Abstract

Background: Emergency and elective C-sections are essential for strengthening obstetric care, particularly in low- and middle-income countries like India. This study aims to (i) estimate the prevalence of emergency and elective C-section deliveries in India, and (ii) examine sociodemographic and clinical factors associated with these two types of procedures.

Methods: Data were drawn from 230,870 individual births that occurred in the five years preceding the survey, using National Family Health Survey (NFHS-V) data. C-section deliveries were categorized into emergency and elective based on reported indications. Descriptive statistics, bivariate analysis, and multivariable logistic regression were used to assess associated factors.

Results: The overall C-section rate was 21.6%, of which 14.2% were emergency and 7.4% elective procedures. Multivariable logistic regression indicated that private facility deliveries were strongly associated with higher odds of overall (AOR=4.17), elective (AOR=2.94), and emergency (AOR=3.08) C-sections compared to public facilities. Rural residence reduced C-section likelihood, while wealthier women, especially the richest, had higher odds. Maternal age, education, and media exposure increased odds across all types. Multiple pregnancies substantially raised C-section risk, whereas higher birth order lowered it. Larger birth size increased emergency C-section likelihood. Regional variation was notable, with southern India showing the highest odds. ANC visits increased overall C-section risk but had limited impact on elective or emergency C-sections.

Conclusions: Addressing regional inequities, improving obstetric care readiness, and reducing unnecessary elective C-sections are critical for improving maternal and neonatal health outcomes.

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