PREVALENCE, ASSOCIATED FACTORS AND OUTCOMES OF CESAREAN DELIVERY AMONG MOTHERS WHO GAVE BIRTH AT PUBLIC HOSPITALS OF HARARI REGION, EASTERN ETHIOPIA

Abstract

Cesarean section refers to the delivery of a fetus, placenta and membrane through the abdominal and uterine incision after 28 weeks of gestation. Currently the rate of cesarean section is increased above WHO recommendation level both in developed and developing countries including Ethiopia. Though there are studies done on prevalence and associated factors of cesarean section in Ethiopia, there is paucity of evidence on the maternal and fetal outcome of cesarean section in Eastern part of Ethiopia. Objective: To assess prevalence, factors associated and outcomes of cesarean delivery among mothers who gave birth in public hospitals in Harari region, from August 15- October 15/2023. Methodology: An institutional-based cross sectional study was conducted among 399 postpartum mothers who gave birth in public hospitals of Harari region from August 15, 2023 to October 15, 2023. Systematic random sampling method was used to select study participants. Data was collected through face to face interview using pretested semi-structured questionnaire and reviewing maternal chart. The data was entered into Epi-Data version 4.6 and analyzed using SPSS version 26. Bivariable and multivariable logistic regression analysis were computed to identify predictors of cesarean section. Adjusted odds ratio with 95% confidence interval was used to describe the association of explanatory variables with the outcome variable and level of significance was set at p<0.05. Results: The overall prevalence of cesarean delivery was 43.6% (95% CI: 38.72, 48.50). History of previous cesarean section [AOR=7.07; 95% CI (2.01, 25.45)], non-cephalic fetal presentation [AOR=3.83; 95% CI (1.09, 13.48)] and prolonged rupture of membrane [AOR=5.38; 95% CI (1.27, 22.83)] were significantly associated with cesarean delivery. Among the women with cesarean delivery, 19.5% of them had adverse maternal outcomes and 24.7% of neonates developed adverse outcomes following cesarean delivery. Conclusion: The prevalence of cesarean delivery in this study was high. History of previous cesarean section, non-cephalic fetal presentation and prolonged rupture of membrane were found to be significantly associated. Therefore, emphasis on clear indications, enlighten mothers concerning to risks and benefits of cesarean section and encouraging mothers to have Vaginal Birth After Cesarean Section is highly advised to minimize cesarean delivery and its adverse maternal and fetal outcome.