Determinants of caesarean section in primigravida and of primary caesarean section in multigravida.

Abstract

Objective: To identify and analyze the medical, obstetrical, and sociocultural determinants contributing to the increasing rates of caesarean section (CS) among primigravida women and primary CS in multigravida women at a tertiary care hospital in Pakistan.
Methodology: This descriptive cross-sectional study was conducted over six months at the Department of Obstetrics and Gynecology, Peoples University of Medical & Health Sciences (PUMHS). A total of 100 pregnant women aged 18–40 years, with parity ranging from 1–5, were recruited through non-probability consecutive sampling. Statistical analysis was performed using SPSS version 20, applying descriptive and inferential statistics to evaluate associations among variables.
Results: Showed that 65% of participants underwent caesarean section, with a higher prevalence among primigravida women, primarily due to non-progression of labor (30%) and fetal distress (24%). In contrast, elective or family-requested CS (20%) were more commonly reported among multigravida women with previous vaginal deliveries. Medi-cal conditions such as gestational diabetes (20%) and pregnancy-induced hypertension (20%) were significantly associ-ated with primary CS. Non-clinical influences, including family pressure and personal preference, emerged as notable determinants, reflecting shifting cultural attitudes toward mode of delivery.
Conclusion: The data highlight the multidimensional character of rising caesarean rates, which are influenced by both clinical indications and modifiable social and behavioural factors.
Key words: caesarian section, global health, healthcare expenditures, maternal and child health.