Assessing socio-ecological factors on caesarean section and vaginal delivery: an extended perspective among women of South-Punjab, Pakistan

Abstract

Research was conducted employing the extended socio-ecological model (ESEM) to examine factors associated with cesarean sections (CSs) and vaginal deliveries (VDs) among the women in our study population. Using the ESEM to determine South-Punjab and Pakistani women’s mode of delivery predictors. The cross-sectional study with a sample size of 908 patients was conducted through private and public obstetrics and gynecology departments in South Punjab, Pakistan, from 12 June 2022 to 29 May 2023. The Chi-square analysis compared baseline variables, delivery outcomes and delivery methods. Logistic regression analysis is used to determine predictive factors. The study revealed that 75.66% of women had CS, while 24.34% had VD. Education level, age, residential area and fetal presentation all had significant associations with mode of delivery. Logistic regression analysis suggested that gynecologist recommendation, belief in CS safety, abnormal fetal presentation, maternal anemia and meconium aspiration syndrome were all significant predictors of CS. The ESEM model concluded that age, fatigue and women’s preference for CS due to its reliability for her and her fetus were predictive factors for mode of delivery choices among South-Punjab Pakistani women.

Keywords:

• ESEM model
• normal delivery
• C-section
• quality of life
• South-Punjab

Author contributions

Muhammad Muneeb Hassan: conceived idea, developed the theory, coding, graph making and performed the computations, final approval of the version to be published. Muhammad Ameeq: contributes to conceptualization, data analysis, coding, graph making and final approval of the version to be published. Laraib Fatima: editing, proofreading, data interpretation, writing and final approval for publication. Sidra Naz: editing, proofreading, data interpretation, writing and final approval for publication. Shabana Abbas: editing, proofreading, data interpretation, writing and final approval for publication. Sheikh Muhammad Sikandar: editing, proofreading, data interpretation, writing and final approval for publication. Alpha Kargbo: editing, proofreading, data interpretation, writing and final approval for publication. All authors contributed to interpreting data, drafting the manuscript and critically revising the manuscript for intellectual content; all authors approved of the published version.

Ethical approval

The Ethical Review Committee of Hospitals District Muzaffargarh, South-Punjab, Pakistan approved 131445-48 on 19 June 2023 that they have no objection and do not raise any ethical issue regarding this research.

Consent form

All patients related to this research gave their consent that they have no issues for research publication purposes.

Disclosure statement

The authors have declared no conflicts of interest.

Data availability statement

Data, models and code supporting this study’s findings are available from the corresponding author.

Additional information

Funding

Funding was not obtained for this study, and neither the research nor the manuscript nor the abstract have been presented elsewhere.