A team of researchers from the health promotion, education, and behavior and health services policy and management departments at the University of South Carolina Arnold School of Public Health along with collaborators from the University of Padova (Italy), Jahangirnagar University, International Center for Diarrheal Disease Research, Bangladesh, and The World Bank (Bangladesh) have completed a study on the determinants of caesarean section in Bangladesh. The paper was published in PLOS One.
The researchers conducted a cross-sectional analysis of data from the nationally representative 2014 Bangladesh Demographic and Health Survey to examine the association of reported complications around delivery and socio-demographics, healthcare and spatial characteristics of mothers who have had a caesarean section within three years preceding the survey.
Caesarean sections have risen worldwide, including in Bangladesh, where rates of this procedure have grown from 3 percent in 2000 to 24 percent in 2014 in both institutional and community-based deliveries. In the 2014 Bangladesh Demographic and Health Survey, researchers collected data from more than 4,600 mothers who gave birth in healthcare institutions in the three years preceding the survey.
In their analysis of this data, the authors found that the average age of the mothers was 24.6 years, with an average of 3.2 years of schooling. Factors such as older maternal age, obesity, residing in urban areas, first birth, maternal perception of large newborn size, husband being a professional, higher number of prenatal visits, seeking prenatal care from private providers, and delivering in a private facility were statistically associated with higher rates of caesarean section.
Based on these findings, the researchers conclude that the Bangladesh health system needs policy guidelines with monitoring of clinical indications of caesarean section deliveries to avoid unnecessary surgeries and complications. Strict adherence to these guidelines, along with enhanced knowledge on the unsafe nature of unnecessary caesarean sections can achieve increased institutional normal delivery in future.