Factors associated with cesarean section for first births in Bangladesh using demographic health survey data 2022

Abstract

A cesarean section (CS) is a remarkable medical advancement that offers a safe and life-saving way to bring babies into the world when traditional delivery poses risks. Several studies found significant association of CS with different demographic, socioeconomic and medical related variables. Therefore, after adjusting the effect of some important selected covariates, the current study aims to determine how the place of delivery (public vs. private hospitals) affects the CS for the first child. Bangladesh Demographic and Health Survey (BDHS), 2022 data was utilized to fulfill the objectives of the research. Only the first birth among reproductive aged women were used in the study since repeated CS are often caused due to CS for the previous child. The frequency distribution of the selected sample was examined using descriptive analysis, and bivariate analysis was performed to assess the percentage distribution of CS delivery for the first child across the study sample. Finally, adjusted and unadjusted associations were measured between CS for first birth and selected covariates employing univariable and multivariable logistic regression, respectively. The study found that 71.3% of the first births at health facilities were delivered via CS. The odds of CS for the first child in private healthcare facilities were significantly higher (AOR = 8.14, 95% CI 6.15–10.768) compared to the public healthcare. The Eastern division showed significant less likely CS than the Western and central division (AOR = 0.442, 95% CI 0.31–0.62). The odds of CS significantly increased with mother’s age at birth when the age is more than 30 years (AOR = 8.286, 95% CI 1.72–39.79). The findings indicated that the place of delivery, women's advance age at first birth and geographic location were significantly associated with the drastic increase in CS rates. These results highlighted the critical need for policy oversight, particularly in the private sector, and advocate for evidence-based procedures, more robust public health systems, and future studies that integrate qualitative and clinical data to inform context-specific interventions.