COMPARATIVE ANALYSIS OF CAESAREAN SECTION AND NON-CAESAREAN SECTION WITH ASSOCIATED FACTORS IN CITIES. Cesarean section rates are increasing worldwide, raising concerns about increased maternal and perinatal morbidity and mortality associated with high cesarean section rates. The aim of this study is to describe the factors associated with the high caesarean section rate in Bangladesh and to describe the postpartum and child complications associated with vaginal or caesarean delivery.
However, socio-demographic, maternal and fetal obstetric factors were also associated with a higher caesarean section rate in Bangladesh. Bangladesh's healthcare system is poorly regulated and there are no evidence-based guidelines for decision-making about cesarean delivery.
Introduction
Background
Haemorrhage, obstructed and prolonged labor are well known to contribute to the major causes of maternal mortality and morbidity in Bangladesh. The maternal mortality ratio (MMR) is a good indicator of the health status of women in a country. Efforts to reduce maternal mortality became a high priority issue for the nation since the late 1990s, and the Government of Bangladesh and UNICEF launched the Emergency Obstetric Care (EOC) program to achieve the goal.
The government of Bangladesh is committed to reducing the maternal mortality ratio (MMR) to 143 deaths per 100,000 live births by 2015 and increasing skilled birth attendance to 50 percent by 2015. A study by the WHO in 2007 found that when the caesarean section rate of a country goes above 15%, the maternal mortality rises, i.e.
Rationale
The researcher hopes that the recommendations made from the findings of this study for hospital management will result in lower cesarean section rates in the hospital. The researcher hopes to contribute to the realization of the third goal of sustainable development in Bangladesh.
Aim and Objectives
Review of literature
- Caesarean rates in Bangladesh
- Caesarean Section Rates in Developing Countries
- Caesarean Section Rates in Developed Countries
- Contributory Factors to High Caesarean Section Rates
- Demographic Factors Associated with High C-Section Rates
- Clinical Factors
- Non- Clinical Factors
- Study Designs of Previous Researchers
- Study Design
- Site of Study
- Sampling
- Sample Size
- Sampling Method
- Inclusion Criteria
- Exclusion Criteria
- Data Collection Tools
- Data Capture and Analysis Strategy
- Data Capture
- Data Cleaning
- Data Coding
- Data Analysis
In poor developing countries, access to health services is limited and caesarean section rates are low. The poorest 20% of the population in 20 countries had a caesarean section rate below one percent, which means very limited access to rescue caesarean section (Ronsmans et al., 2006). Similarly, in poorer African countries such as Somalia, where access to health services remains a challenge, caesarean section rates are low and women resist caesarean sections (Borkan et al., 2010).
In developed countries, studies have been done to show the reasons for the high and increasing cesarean section rates (Barber, 2011) as well as efforts to reduce the cesarean section rates. Other independent demographic variables that have been found to be positively associated with caesarean section rates are increasing parity and increasing body mass index (Dereure et al., 2000). A national audit report of caesarean sections in the United Kingdom found higher rates of caesarean section in black and Caribbean women than in white women.
These factors are thought to be responsible for the higher caesarean section rates observed in black women (Parajothy and Thomas, 2001). Other clinical factors such as multiple pregnancy, macrosomia, antepartum haemorrhage and failed induction contributed less significantly to the increase in caesarean section rates (Barber et al., 2011). Caesarean section outcomes are often studied when describing clinical factors associated with cesarean section rate.
In the United States, managed care resulted in some reductions in cesarean section rates in some managed care plans compared to statewide average rates (Roohan et al. Many of the previous studies that addressed factors associated with high cesarean section rates used quantitative cross-sectional descriptive With these methods, the research teams were able to identify practice, environmental, resource and population factors that contribute to caesarean section rates.
Results
Caesarean Section Rates in Rural and Urban Area of Chattogram division
Demographic Characteristics
- Age
- Body Mass Index (BMI)
- Mother‘s occupation
- Mother‘s education
- Husband‘s employment status
- Husband‘s education
By far the largest majority of mothers completed their studies and graduated in an urban area, where about half of mothers completed high school. Employment status of husband: As shown in the table of husbands, they were day laborers, which reflected the low socio-economic status of the majority of the husband and reflected the low socio-economic status of the majority of the rural study population. were job holder and businessman in urban area. Details about the type of occupation or average monthly income were not included in the questionnaires.
Spouse's education: Most rural men have completed their primary education and only 15 (7.7%) completed their diploma at their primary education level, and only 15 (7.7%) completed their diploma, where about three-quarters of men in the city graduated. their graduation level.
Bivariate Analyses of Variables
- Bivariate Analyses of demographic Variables
- Bivariate Analyses of Fetal Obstetric Variables
- Bivariate Analyses of Maternal Obstetric Variables with vaginal and
- Decision making process for vaginal or caesarean delivery
- Bivariate Analyses of Information Variables provided to mother prior to
- Bivariate Analyses of Postpartum Complications with Vaginal and
- Bivariate Analyses of Child Health Outcomes with Vaginal and Caesarean
Correlation between the mother's occupation and vaginal and caesarean section The results show that the mother's occupation had a statistically significant association with caesarean section (Chi-Square test with one degree of freedom, p = 0.001). Association of mother's education with vaginal and caesarean section The results show that there was a statistically significant association between mother's education with vaginal and caesarean section, Chi-square test with 3 degrees of freedom. Correlation between the man's occupation with vaginal and caesarean section The results show that there was a statistically significant correlation between the man's occupation with vaginal and caesarean section, Chi-square test with 2 degrees of freedom.
Association of the man's education with vaginal and caesarean section The results show that there was a statistically significant association between the man's education with vaginal and caesarean section, Chi-square test with 3 degrees of freedom. The results show that all fetal obstetric variables such as breech presentation, large baby and twins/triplets had a statistically significant association with vaginal and caesarean section (Chi-Square test with one degree of freedom, p = 0.001) illustrated in table: 4.3. Bivariate analyzes of maternal obstetric variables with vaginal and caesarean section in studied women cesarean section in studied women.
Association of urinary incontinence with vaginal and cesarean section The results show that urinary incontinence had no statistically significant association with vaginal and cesarean section (Chi-Square test with one degree of freedom= . 2.177, p = 0.140). The results show that prolapsed pelvic organ had no statistically significant correlation with vaginal and caesarean section (Chi-Square test with one degree of freedom = 0.606, p = 0.436). The results show that abdominal distension had a statistically significant correlation with vaginal and caesarean section (Chi-Square test with one degree of freedom= 40.621, p = 0.00) illustrated in table: 4.5.
Association between pelvic abortion with vaginal and cesarean section The results show that abortion had no statistically significant association with vaginal and cesarean section (Fisher's exact test, p = 0.076). The results show that cold fever had a statistically significant association with vaginal delivery and caesarean section (Likelihood Ratio test with 2 degrees of freedom = 106.135, p = 0.00). The results show that pneumonia had a statistically significant association with vaginal and caesarean section (Chi-Square test with one degree of freedom = 31.676, p = 0.00).
Discussion
- Demographic characteristics
- Obstetric Factors Associated with Caesarean-section
- Decision making process for vaginal or caesarean delivery
- Information being provided to mother prior to delivery
- Maternal postpartum complications according to delivery mode
- Child Health Outcomes with Vaginal and Caesarean delivery
They also found that CS use was significantly higher among mothers with higher education. In this study, it was found that the husband's education level and profession significantly affects the cesarean section rate. It has also been found that higher economic status of the spouse is significantly related to the cesarean section rate among women.
46.9% were from the employee and business family respectively with SK. 2008) conducted a study on the disparity in maternal health care services in Bangladesh and found that only 3.3% of women from poor families had SK, while 28.4% of women from rich families had CS. This is also supported by Kamal's (2013) study, which found that the likelihood of CS increased as women's wealth status increased. According to BDHS (2014), among women with higher wealth status, half of the births were performed by CS. 2008) also found that women with higher socioeconomic backgrounds and better access to antenatal services were more likely to undergo CS.
This is also supported by the study by Inyang-Out (2014)) who found that the probability of CS increased with the increase in CPD and he found that in his study 30.6% caesareans had CPD. However, in some studies, for example, Nazneen et al. 2011) found that patients with previous CS are more likely to undergo a repeat CS in subsequent pregnancies due mainly to safety concerns. 2011) also found that the same patient goes to the hospital for her successive births because they previously found CS less painful and convenient.
The study found that early in the women's pregnancies, they had a preference for normal delivery, but they changed their decision to CS after repeated interaction with their doctors. They found that about 60% of women reported that she and her family made the decision for her cesarean delivery. Another study conducted by Keag et al, (2018) also found that compared to vaginal delivery, cesarean delivery was associated with a reduced risk of urinary incontinence and pelvic organ prolapse.
Conclusions
Bangladesh Demographic and Health Survey (BDHS).2007.National Institute of Population Research and Training (NIPORT), Mitra and Associates, and Macro International. Dhaka, Bangladesh and Calverton, Maryland, USA: National Institute for Population Research and Training, Mitra and Associates, and Macro International. National Institute of Population Research and Training, Ministry of Health and Family Welfare, Dhaka, Bangladesh.
Use of a cesarean section classification system based on population characteristics as a way to monitor obstetric practice. Community factors influencing increased caesarean section rates in developing countries: a six-country analysis. The effect of population group classification as a specific example of racial categorization on caesarean section rates in South Africa.
Determinants of caesarean section in Bangladesh: cross-sectional analysis of Bangladesh Demographic and Health Survey 2014 data. Cesarean birth in India: causes and concerns Researcher, Jawaharlal Nehru University, New Delhi – 110067. Cesarean birth rates and pregnancy outcomes: 2005 WHO global survey on maternal and perinatal health in Latin America.
I am conducting a qualitative research study on ―Comparative analysis of cesarean and non-cesarean delivery with its associated factors in urban and rural areas of Chattogram, Bangladesh.‖ The aim of this study is to determine the cesarean rate in urban and rural determine areas. rural area of Bangladesh and the drivers of caesarean section. Comparative analysis of cesarean and non-cesarean delivery with its associated factors in urban and rural areas of Chattogram, Bangladesh.
