Non-obstetric Causes of Cesarean Section in Iranian Pregnant Women Referring to Medical Services Commission

Abstract

Background: Despite the implementation of the Health Transformation Plan in recent years, the cesarean section (CS) rate has increased in private and public centers in Iran. Accordingly, Iran is the first among the four countries in the world with the highest CS rate. Objectives: The present study aimed to investigate the non-obstetric causes of CS in mothers who were referred to the Medical Services Commission of Alborz province, Iran, to review their requests for CS. Methods: In this cross-sectional study, 312 subjects were selected based on a census of all clients by the Midwifery Office of Alborz province, whose requests for CS for non-obstetric reasons were submitted to the Medical Services Commission in 2020. The information in this study was collected using a researcher-made questionnaire containing 26 items in two sociodemographic and medical sections. Results: The highest frequency of sociodemographic factors was observed for the age range of 20 - 30 years (n = 163, 52.2%), the educational level of diploma and higher (n = 236, 75.6%), urban residence (n = 274, 87.8%), and no complementary insurance (n = 258, 82.7%). The frequency distribution of the non-obstetric reasons of the participants was reported as 83 (26.6%), 60 (19.2%), 25 (8%), 24 (7.7%), 20 (6.4%), 14 (4.5%), and 86 (27.6%) for lumbar disc disease, eye diseases, repeat CS, genital warts, in vitro fertilization, fear of childbirth pain, and other causes, respectively. There was a significant association between the reason for requesting CS and the age group (P < 0.001), the type of insurance (P = 0.043), and the mother’s educational level (P < 0.001). Conclusions: In the present study, most of the women in the younger age group and non-employees requested a CS for non-obstetric reasons.