Rate of cesarean delivery at hospitals providing emergency obstetric care in Bangladesh

ObjectiveTo assess the rate of cesarean delivery and its indications at public emergency obstetric care (EmOC) hospitals in a district in Bangladesh.MethodsIn a retrospective, cross-sectional study, data were extracted from the Safe Motherhood Promotion Project database and operation theater registers for cesarean deliveries at three district and three subdistrict EmOC hospitals in Narsingdi between January 1 and December 31, 2008. Information on cesarean deliveries and their indications, and maternal and neonatal outcomes were analyzed descriptively.ResultsAmong 3329 deliveries, 1075 (32.3%) occurred by cesarean. The frequency of cesarean delivery ranged from 17.8% (147 of 824 deliveries) to 56.3% (174 of 309) among the six hospitals. Information on indications was available for 1043 cesarean deliveries. The main indications were previous cesarean delivery (251 deliveries, 24.1%), fetal distress (228, 21.9%), and prolonged or obstructed labor (214, 20.5%). There were no maternal deaths, but 10 (1.0%) cesarean deliveries resulted in stillbirth.ConclusionThe overall rate of cesarean delivery was high at EmOC hospitals. Interventions to improve decision making and limit possible unnecessary cesarean operations are needed.