Exploring the Overuse of Cesarean Delivery Among Professional Women in Bangladesh:

Insights for Maternal Health Policy

Abstract

A caesarean section (CS) is widely recognized as the most preferred option for severe labor problems.  The WHO made recommendations that a range of 5% to 15% should be a desirable standard for CS. Bangladesh is witnessing an increasing condition on the other hand.  A significant factor contributing to this CS acceleration is social perception.  Consequently, 797 graduate women, aged 25 to 49, who made up the whole population of Dhaka, were polled and interviewed in order to look into the psychological factors. It could be seen that most graduate working women (78.24%) whether they had children or not, had a perception that caesarian section was not painful where excessive pain occurred during vaginal delivery (85.76%). 33.40% of graduate working women thought, due to avoiding excessive pain, women chose caesarian section while they had a chance to go through vaginal delivery. Moreover, 26.71% of graduate working women thought that fear of painful vaginal delivery inspired some to go for caesarian section over vaginal delivery. Furthermore, about safety issue, most graduate working women (61.94%) opined that caesarian delivery was safer for babies. Again, 39.89% of graduate working women believed that, to ensure safe delivery, women chose caesarian section over vaginal delivery. On the contrary, 64.21% of respondents believed that there was severe suffering for mothers after caesarian section and 54% of the total respondents identified caesarian section as unsafe for mother. 11.62% of future mothers wanted to go through caesarian section and CS was the first choice among 37.99% mother. Similar reasons were found for that mother who chose CS over vaginal delivery.  These findings highlight that fear of pain, perceived infant safety and uncertainty about labor outcomes are major contributors to high CS rates in this population. As Bangladesh’s CS rate exceeds international recommendations, it is crucial for policymaker and healthcare providers to address these perceptions through targeted education and interventions, in order to promote informed delivery choices and reduce unnecessary CS.