Prevalence and determinants of Caesarean section delivery in Bangladesh: Bangladesh Demographic Health Survey 2017-18.

Abstract

Background: Caesarean delivery is a life saving surgical method for pregnant mother and baby in a critical situation. Nowadays it has arisen as a problem in many developing countries like India, Nepal, Bangladesh and some other asian countries by excessive unnecessary practice. It has severe health adverse issues as well as it brings a huge economic burden.

Method: We have used Bangladesh Demographic Health Survey data (BDHS) 2017-18. It was aimed to give accurate estimates for key indicators at the national level. Each team of data collectors received intensive training to carry out household listing and field activity. First we had to get approval from the DHS program, then from the Ethical Review Committee of Asian University for Women (AUWERC) by following their steps and acknowledgement.

Findings: A total of 5007 women identified who delivered: 1675 (33.5%) of them had a CS delivery, while the rest 3332 (66.5%) had a vaginal delivery. Dhaka division had the greatest percentage of CS deliveries (6.55%), followed by Khulna (4.75%), Chittagong (4.63%), Rajshahi (4.01%), Sylhet (3.65%), Rangpur (3.49%), Mymensingh (3.39%), and Barisal (2.89% ). Mothers' age 35-39 years (AOR = 2.612, 95 %CI = 1.341 to 5.089) are more likely to go for c-section delivery, wealth index middle class(AOR = 1.076, 95 percent CI = 0.814 to 1.423) and rich (AOR = 1.201, 95% CI = 0.915 to 1.576) are more likely to go for CS delivery, antenatal visit 1 to 4 (AOR = 1.917, 95% CI = 1.014 to 3.622), and 5 or more (AOR = 2.998, 95% CI= 1.573 to 5.717) are more likely to go for c-section delivery, mothers who are overweight (AOR = 1.556, 95% CI = 1.246 to 1.943), multiple births (AOR = 1.043, 95% CI = 0.520 to 2.090) are more likely to go for c-section delivery, and Mother who are not working (AOR=0.717, 95% CI= 0.594 t0 0.881) has less likely to go for CS delivery.Women who gave birth her first child at the age of more than 20 (AOR= 1.474, 95% CI=1.112 to 1.955) are more likely to go for CS delivery. Additionally, place of residence, number of family members, birth order, and Bangladesh divisions were all linked to CS delivery.

Conclusion: One third of the study women have had C-section section delivery, which is substantially high. CS delivery can be used to save lives in emergency circumstances. Rational decisions should be taken for reducing the negative health effects and financial burden to the families.