Prevalence and determinants for having caesarean section in year 2002 delivery in the narlıdere health district

Prevalence and Determinants for Having Caesarean Section in Year 2002Delivery in The Narlıdere Health DistrictSerap KonakçıObjective: This study examined to estimate rate and determinants for havingcaesarean delivery between in the Narlıdere Health District, in 2002.Methods: A cross-sectional study was performed. The study group consistedof 494 women who gave live birth in the District in 2002. Data onsociodemographic-economic charecteristics, maternal history, antenatal care,labor, infant?s charecteristics were collected in face to face interviews.Analyses were performed with SPSS 11.0 and Epi Info 2002 Statcalc.Results: Response rate 85.4 percent. Caesarean rate 46.9 percent. Majorindications for caesarean included previous caesarean in multiparous andmathernal choice in primiparous. Univariate analysis showed the rate ofcaesarean increased significantly with increasing maternal age and level ofeducation (for all p<0.001). Occupation, high level of income, choosed privateand only obstetrician-gynecologist obstetric care, delivered private hospitalswere significiant associate with high caesaren rate (for all p<0.001).Multiple Logistic Regression modeling adjusted for maternal age, level ofeducation and income showed choosed only obstetrician-gynecologistobstetric care (OR 3.47 %95 CI 1.66-7.29) and delivered private hospitals (OR3.65 %95 CI 2.01-6.62) to have a significantly increased risk for caesareancompared with choosed midwife or midwife+obstetrician-gynecologistobstetric care and delivered public hospitals.Result: In this study caesarean rate was high in the District. Non medicalfactors seemed more important than medical factors in the decision to carryout a caesarean section. Effective national health policies should beimplemented by the Ministry of Health to reduce high levels of caesarean.Training should be provided to all health care givers on evidence based clinicaldecision making including obstetrician-gynecologist.Keywords: Caesarean section, cause of caesarean section, birth.