Caesarean section rate and its determinants in a rural area of South India
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20163370Keywords:
Caesarean section, Vaginal birth after caesarean, UltrasonographyAbstract
Background: The world is currently witnessing an increase in the rate of caesarean sections which can be ascribed to many factors including socio-demographic factors and personal preferences apart from the clinical indications. This study is done to assess the rate of caesarean section in rural Kerala of South India and to determine the factors associated.
Methods: A community based cross sectional study using a pretested semi-structured questionnaire was conducted among mothers who delivered between April 2011- march 2012 in a rural area of Thrissur district in Kerala, South India. Analysis was done using SPSS16.
Results: Rate of caesarean section is 37.7%. The major indications were previous caesarean sections (40.44%), failure of labor to progress (22.47%) and fetal distress (14.6%). Univariate analysis showed significant association between caesarean section and higher educational status of the women and husband, higher occupational status of the women and husband, and undergoing ultrasonography >3 times in the antenatal period. On multivariate analysis higher occupational status of women (OR [CI] =3.35 [1.03-10.8]), multiparity (OR [CI] =1.96 [1.05-3.6]), and >3 ultrasonograms (OR [CI] =2.05 [1.08-3.89]) were found to be significant risk factors.
Conclusions: Rate of caesarean section in present study is above the expected levels. Study brings out association of woman’s occupation, parity and number of ultrasonography with caesarean sections. It is important to make the public aware regarding the benefits of natural births. Government level policies supporting normal deliveries should be advocated.References
World Health Organization. Monitoring emergency obstetric care a handbook. 2009. available from URL:http:///www.who.int/reproductivehealth/publications/monitoring/.../en/
Pai M. Unnecessary Medical Interventions: Caesarean Sections as a Case Study. Economic and Political Weekly. 2000;35(31):2755-61.
Mishra US, Ramanathan M. Delivery-related complications and determinants of caesarean section rates in India. Health Policy Plan. 2002;17(1):90-8.
International Institute for Population Sciences (IIPS), Ministry of Health and Family Welfare, GOI. National Family Health Survey-3 2005-2006.Mumbai; 2007.
Hemachandran K. Burden cause and cost of Caesarean section. Working paper series, Working paper no: 2: May 2003; p 24
UNICEF, Ministry of Health and Family welfare, GOI. National fact sheets. Coverage evaluation Survey.2009
World Health Organization. World Health Statistics 2014. WHO. Geneva; 2014.
World Health Organization. World Health Statistics 2014. WHO. Geneva; 2013.
Unnikrishnan B, Rakshith Prasad B, Aishwarya Amarnath, Nithin Kumar, RekhaT, Mithra et al. Trends and Indications f or Caesarean Section in a tertiary care Obstetric Hospital in Coastal South India., Kasturba Medical College, Mangalore (Manipal University). AMJ. 2010;3(12):821-5
Nahar K. Indications of Caesarean Section - Study of 100 cases. J Shaheed Suhrawardy Medical College. 2009;1(1).
Ghosh S. Increasing trend in caesarean section delivery in India: Role of medicalization of maternal health. Working paper 236.available at www.isec.ac.in/ WP % 20236% 20- % 20 Sancheeta % 20 Ghosh. pdf. Accessed 9 June 2013.
Chacham AS, Perpetuo. The incidence of caesarean deliveries in Belo Horizonte, Brazil: social and economic determinants. Repr health matters. 1998; 6(11):115-21.
Kaur J, Singhand S, Kaur K. Current trend of caesarean sections and vaginal births. Advances in Applied Sci Res. 2013;4(4):196-202.
