Caesareansection (C-section) is one of the most common surgeries in the world. Theprocedure is often performed without medical need, thus putting women and theirneonates at risk of short- and long-term health problems 1. Recent reports have suggested that the rates of C-section continue toskyrocket, particularly in high- and middle-income countries 12.
The international healthcare community consideredthe ideal rate for cesarean sections tobe between 10% and 15% 123. TheMalawi government follows the United Nations (UN) indicators, which recommendthat a minimum of 5% and a maximum of 15% of all births should be delivered byC-section 4. However, the World Health Organization (WHO)underscores the importance of focusing on the needs of the patient and discouragesthe practice of aiming for target rates 2. C-section may be necessary when vaginal delivery posesa risk to the mother or neonate particularly due to fetal distress, prolongedlabor, or because the baby is presenting in an abnormal position 13.
Unfortunately, the procedure can lead to significantproblems, disability or death, predominantly in settings that lack thefacilities to conduct safe surgeries or treat potential complications 23.Previousstudies in many settings have reported that the causes of an increase in C-sections are multifactorial and poorlyunderstood 5. Notably, changes in maternal characteristics (i.e.higher educational education, rise in maternal age, prior cesarean section, prolongedlabor, and increasing maternal Body Mass Index) 56, infant characteristics (i.e. baby weight – suspectedlow infant birthweight or macrosomia, length of the baby) 67 and professional practice styles, increasingmalpractice pressure – private hospital status, as well as economic,organizational, social and cultural factors have all been implicated in an increase in C-sections 5.
C-section is one of the most important risk factors for postpartum maternal infection whichaccount for approximately 10% of pregnancy-related mortality and it carries a risk of infection 5 to 20 times that of vaginaldelivery 8910. In Malawi, since 1992,the rates of C-sections have been on the riseas it was reported that only 3% of births occurred with C-section in 1992-2000compared with 5% in 2010 and 6% in 2015-16 11. For better results on C-section,it is necessary to contextualize the sociocultural determinants. Thus, thepresent study aimed to investigate the associated factors of C-sections from 2004 to 2015 using the population-based data