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. 2024 Jan;53(1):219-227.
doi: 10.18502/ijph.v53i1.14698.

A Higher Maternal Education Level Could Be a Critical Factor in the Exceeded Cesarean Section Delivery in Indonesia

Diah Yunitawati  1 , Leny Latifah  1 , Indri Yunita Suryaputri  1 , Agung Dwi Laksono  1
Affiliations

A Higher Maternal Education Level Could Be a Critical Factor in the Exceeded Cesarean Section Delivery in Indonesia

Diah Yunitawati et al. Iran J Public Health. 2024 Jan.

Abstract

Background: Cesarean section (CS) could be life-saving with medically indicated, but without it, both women and children could be at risk. The maximum rate for CS is 15%, but it tends to exceed globally.

Objective: We aimed to analyze the education level's role in the delivery of CS in Indonesia.

Methods: We used the 2017 Indonesia Demographic and Health Survey data. The study sampled 15,357 women who delivered in five last years. Besides delivery mode and education level, the study also used nine control variables: residence, age, marital, employment, parity, wealth, insurance, antenatal care, and birth type. The study employed a binary logistics regression.

Results: The results show women with secondary education (16.5% CS) are 2.174 times (AOR 2.174; 95% CI 1.095-4.316), and higher education (33% CS) are 3.241 (AOR 3.241; 95% CI 1.624-6.469) times more likely to deliver by CS than no-school education (4.4% CS). There was no significant difference between primary (9.1%) and no-education women. Apart from education, primiparous women, age 34-34 yr, attending antenatal care ≥4 times, non-poorest, having insurance, living in the city, and being unemployed also related to higher risk of CS.

Conclusion: Exceeded CS in Indonesia occurs mostly in higher education women. Higher education women were more likely to access more information and technology, therefore health promotion on healthy normal birth on social media or m-Health (mobile device-based health promotion) and involving health authorities at every level were suitable to reduce the overuse of the CS.

Keywords: Cesarean section; Childbirth; Education level; Maternal health; Public health.

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Figures

Fig. 1:
Fig. 1:
Distribution of delivery by proportion by the province in Indonesia, the IDHS 2017
See this image and copyright information in PMC

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References

    1. Betran AP, Torloni MR, Zhang JJ, Gülmezoglu AM. (2016). WHO statement on caesarean section rates. BJOG, 123 (5): 667–70. - PMC - PubMed
    1. World Health Organization (1985). Appropriate technology for birth. Lancet, 2 (8452): 436–7. - PubMed
    1. Betran AP, Ye J, Moller A-B, Souza JP, Zhang J. (2021). Trends and projections of caesarean section rates: global and regional estimates. BMJ Glob Health, 6 (6): e005671. - PMC - PubMed
    1. National Institute of Health Research and Development of Indonesia (2019). The 2018 Indonesia Basic Health Survey: National Report. National Institute of Health Research and Development, Jakarta.
    1. National Institute of Health Research and Development of Indonesia (2013). The 2013 Indonesia Basic Health Survey: National Report. National Institute of Health Research and Development of Indonesia, Jakarta.

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