Preference of cesarean delivery and its associated factors among pregnant women attending ante natal care at public health facilities of Debrebrehan City, Ethiopia: Cross-sectional study

Abstract

Background: A Caesarean section is a surgical procedure used to prevent or treat life-threatening maternal or fetal complications. Women's delivery preferences have become a global issue of interest to many researchers and clinicians, especially given the ever-increasing rate of cesarean sections. There is limited data on the preference for cesarean delivery and its associated factors for Ethiopian women, particularly in the study area. The aim of the study is to assess the preference for cesarean delivery and its associated factors among pregnant women attending antenatal care at public health facilities in Debre Berhan, Ethiopia, in 2023.

Methods: An institution-based cross-sectional study design was done from May 5-20, 2023, among 512 participants, and a multi-stage sampling technique was used. The data were collected by using interviewer-administered semi-structured questionnaires. The data were entered by Epi Data version 4.6 and then transferred to SPSS version 25 for analysis. With logistic regression, those variables with a p-value <0.25 in the bivariate analysis were candidates for multivariate logistic regression, and variables with a p-value <0.05 were considered statistically significant.

Result: The preference for a cesarean section was 26%, with a CI of 22.3% to 29.9%. Pregnant mothers who were not satisfied with their previous intrapartum care (AOR; 6.3 CI = (3.5-11), P = 0.01), had no knowledge about cesarean delivery (AOR; 2.9; 95% CI = 1.6-5.3), P = 0.01), had a previous history of spontaneous abortion (AOR; 3.1; 95% CI = (1.5-6.3), P = 0.001), lived in an urban area (AOR; 1.9; 95% CI = (1.0-3.5), P = 0.038), and had a current pregnancy-related problem (AOR; 4.8; 95% CI = 1.9-10), P = 0.001) were significantly associated with the preference for cesarean delivery.

Conclusion: In this study, the preference for cesarean delivery was high as compared to the World Health Organization recommendation. Pregnant mothers who were not satisfied with their previous intrapartum care, had no knowledge about cesarean delivery, had a previous history of spontaneous abortion, had an urban residence, and had a current pregnancy-related problem were significantly associated with a preference for caesarean delivery. Clinicians who are working in the delivery room should improve their service provision by using patient-centered care to increase patient satisfaction.

Fig 1. Schematic representation of sampling procedure for determining the preference of C/S and its associated factors among pregnant mother attending ANC at public health facilities of Debre Birhan town, Ethiopia, 2023.

Fig 2. Maternal preference of caesarean delivery among pregnant women attending ANC in selected public health facilities in Debre Berhan, Ethiopia, 2023.