Factors influencing the increasing trend of cesarean section in public tertiary hospital IGMH, in Male, Maldives

Abstract

Trends of caesarean sections (C-section) worldwide shows that the rate of C sections has increased globally, regionally and at national levels with an average global increase of 12.4% for the period between 1990 and 2014. Increasing number of Caesarean Section in Maldives is a growing concern that needs further investigations. on the objective of this study was to identify the individual factors, medical factors, non-medical factors that influence the increasing rate of C-sections and to determine the relationship between those factors and the mode of delivery in Maldives.. A descriptive cross-sectional research design and a quantitative method were used on a stratified random sample of women. Data was collected by using a researcher administered questionnaire, from 97 women who had normal delivery and 70 women who had a C-section. Both descriptive and inferential statistics were performed by using SPSS and “R” software. The individual factors that were most influential include awareness of the risk factors and indications of LSCS and knowledge of how an LSCS procedure take place which were found to be different between the two groups of women. Medical factors such as the number of pregnancies and the weight of the baby were influential factors. Non-medical factors such as society‟s influence on the mode of delivery and availability of health financing for delivery were similar between the two groups of women. This study also highlighted a statistically significant association between the mode of delivery and knowledge of the procedures of LSCS, knowledge of the indications for LSCS, health status of the mother, presence of a chronic disease in the mother and the number of pregnancies. This study has identified the need to provide knowledge and awareness to women on the different types of delivery method and provides evidence for policymakers to focus on ways to reduce the rate of C-sections to fit to the WHO recommended proportion of C-sections in a country.