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Abstract:
Cesarean section (CS) delivery is one of the
life-saving medical practices that save the
lives of both mothers and newborns. However,
non-medically indicated CS may have a long-
term effects on both maternal and child
health. In Bangladesh over the last three
decades, the percentage of CS has increased
almost 15-fold. Studies have described
sociodemographic, maternal, child, and
community factors that may affect CS
delivery. In this study, trends in CS in
Bangladesh from 2007 to 2017 and the
correlates of CS were analyzed with data from
Bangladesh Demographic and Health Surveys.
The results showed that from 2007 to 2017,
the adjusted odds ratio (AOR) for higher
education in CS delivery decreased from 4.6
to 1.8, which indicated reduced differences
in the odds of CS among women with the
highest and lowest education levels. The
adjusted odds ratio for the richest wealth
quintile peaked at 5.3 in 2011 but fluctuated
and showed the richest-poorest gap narrowing
to 3.3 by 2017. Unemployed mothers had a 30%
lower odds of CS in 2017, but were
insignificant in the previous years. In all
four surveys, birth order consistently showed
lower odds (AOR<1) of CS delivery for the
second and third child, as well as obese
mothers and mothers who have children at
older age being more prone to having CS
deliveries. In addition, the AOR for maternal
age at first birth over age 25 decreased from
5 in 2007 to 3.1 in 2017. The AOR for 4+
antenatal visits dropped from 3.2 in 2007 to
approximately 2 in 2017. A geospatial
variation of the CS trends was also observed
across eight divisions of Bangladesh over the
four surveys, with Dhaka consistently higher
until 2014, and Khulna increasing to 1.7 by
2017. Mass awareness, as well as government
and nongovernmental interventions, are
necessary to reduce the number of CS
deliveries in Bangladesh.
Trends in Correlates of Cesarean Section in Bangladesh: Insights from BDHS 2007–2017 (PDF, 815K)