Socioeconomic, geographic and health system factors associated with rising C-section rate in Indonesia: a cross-sectional study using the Indonesian demographic and health surveys from 1998 to 2017

Wyatt, Sage; Silitonga, Permata Imani Ima; Febriani, Esty; Long, Qian

doi:10.1136/bmjopen-2020-045592

Cited by 13 publications

(15 citation statements)

References 23 publications

(19 reference statements)

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“…(19) Women's socioeconomic status and health system factors were associated with the increased use of CS. (20) In contrast, a Bangladesh study found that the logistic regression analysis has traced no significant variation in CS rate among mothers of varying educational levels as compared to the reference group (mothers with no education) (p>0.05). Similarly, mothers' religious status, age at first childbirth, age at first marriage, working status, exposure to media, including wanted indexed child and husband's educational level, resulted in no significant difference in CS rate among various groups as compared to their corresponding reference groups.…”

Section: Introductionmentioning

confidence: 90%

Highest economic status increases risk of cesarean section in women of childbearing age

Idris

Anggraini

2022

Univ Med

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BACKGROUNDCesarean section (CS) rates that are higher than the WHO recommendation may pose morbidity and mortality risks for both mother and child. In recent years, the number of CS deliveries has been increasing in developed and developing countries. The aim of the present study was to determine the rate of CS delivery and socioeconomic and demographic factors as risk factors of cesarean delivery in women of childbearing age. METHODSThis cross-sectional study used data from the 2017 Indonesian Health Demographic Survey (IDHS). The research subjects were 14,724 women of childbearing age aged 15-49 years who had given birth and met the inclusion criteria. The rate of CS was determined and the associations between independent and dependent variables were explored using logistic regression. RESULTSThe CS rate was 17.9%. Variables that had a significant relationship with cesarean delivery were geographic region, economic status, occupation, education, birth attendant, insurance ownership and antenatal care visits. The most dominant influencing variable was the highest economic status (OR 3.566; 95% CI: 2.857-4.452). Respondents with the highest economic status had a 3.5 times greater risk of having a cesarean delivery than subjects with the lowest economic status after controlling for the other variables. CONCLUSIONThis study demonstrated that the highest economic status increased the risk of CS delivery in women of childbearing age. The current epidemiological findings and evidence suggest adopting and implementing some strict guidelines in the health system to avoid unnecessary delivery by CS.

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Section: Introductionmentioning

confidence: 90%

Highest economic status increases risk of cesarean section in women of childbearing age

Idris

Anggraini

2022

Univ Med

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“…This indicates that there has been a decrease in normal vaginal delivery in recent years (Bhandary, 2017;Borem et al, 2020). The increase in the average trend of cesarean sections also occurred in Indonesia, from 2% in 1991 to 16% in 2012 (Wyatt et al, 2021). Even though most of the causes of cesarean sections were due to obstetric complications, the concern about excessive pain during delivery and inability to wait for normal delivery, which usually takes quite a long time, also caused an increase in cesarean sections in those times (Sungkar & Basrowi, 2020;Sungkar et al, 2019).…”

Section: Introductionmentioning

confidence: 97%

“…However, the increasing trend in a cesarean section has continued in the last few decades, from 6.7% in 1990 to 19.1% in 2014 (Wyatt et al, 2021). This indicates that there has been a decrease in normal vaginal delivery in recent years (Bhandary, 2017;Borem et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

The Effect of Pelvic Rocking Exercise with a Birth Ball and SP6 Acupressure on Duration of the First and Second Stage of Labor

Karningsih

Purwanti

Yulfitria

et al. 2022

Nurs. Med. J. Nursing

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Background: Long duration of labor increases the pain that a mother experiences. Several non-pharmacological methods, such as pelvic rocking exercises and SP6 acupressure, have been discovered to reduce pain and accelerate labor duration. It needs to be clarified which of the two methods is more effective.Purpose: This study aimed to assess the effectiveness of pelvic rocking exercise with a birth ball and SP6 acupressure in shortening the duration of the active phase in the first and the second stage of labor.Methods: This study used a quasi-experimental design involving 64 mothers in the first stage of normal delivery who were recruited using propensity score matching sampling. The participants were divided into two intervention groups (the pelvic rocking exercise with a birth ball and SP6 acupressure). Each respondent in the two intervention groups was monitored for progress of labor during the active phase in the first stage using a partograph starting from cervical dilatation of 4 cm to 10 cm. The duration of the second stage was assessed by calculating the length of time from cervical dilatation of 10 cm to the delivery of the entire baby. The Mann-Whitney U test was performed to assess the difference between the two interventions in the two stages of labor assessed.Results: There was a difference in the duration of labor in the first stage (p=0.00) and the second stage (p=0.001) between the groups given the pelvic rocking exercise with a birth ball and the SP6 acupressure. The pelvic rocking exercise with a birth ball was found to be more effective in shortening the duration of the active phase in the first stage (Mean rank=19.83) and the second stage of labor (Mean rank=24.56) compared to SP6 acupressure (Mean rank of the first stage=45.17 and Mean rank of the second stage=40.44).Conclusion: The pelvic rocking exercise was found to be more effective compared to SP6 acupressure in shortening the duration of the active phase in the first and the second stage of labor. Pelvic rocking exercise can be implemented to help accelerate labor duration so that mothers can feel more comfortable during the labor.

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“…Cesarean section (C-section) is becoming more popular as a delivery method. C-section rates have risen worldwide from 4% in 1998 [1] to 21.1% in 2018 [2], while, in Indonesia, they have risen from 9.8% in 2013-18.5% in 2017 [3], [4]. With the increasing numbers of C-sections performed each year, proper anesthetic and post-operative pain management are critical for better results [2].…”

Section: Introductionmentioning

confidence: 99%

Comparison of Pain Control and Inflammatory Profile in Cesarean Section Patients Treated with Multimodal Analgesia Utilizing Paracetamol and Ibuprofen

Gaus

Afif

Ambo

et al. 2023

Open Access Maced J Med Sci

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AIM: This single-blind study aimed to compare the combination of paracetamol with various doses of ibuprofen as multimodal analgesia in C-section surgery patients under spinal anesthesia. Levels of interleukin (IL)-6 and C-reactive protein (CRP) were analyzed as markers of inflammation. METHODS: Treatment groups (20 patients each) were: Group A, 750 mg paracetamol and 400 mg ibuprofen; Group B, 750 mg paracetamol and 600 mg ibuprofen; and Group C, 750 mg paracetamol and 800 mg ibuprofen. Degree of pain (movement and rest), scored using the numeric rating scale (NRS) and levels of IL-6 and CRP were assessed at various time points within 24 h of surgery. Side effects and numbers of subjects requiring rescue fentanyl administration were also recorded. RESULTS: Group C showed a rest NRS score of 1.00 ± 0.00 6 h postoperatively, compared with 2.00 ± 0.00 in Group B and 2.35 ± 0.87 in Group A. 4 h postoperatively, movement NRS scores were 1.00 ± 0.00 for Group C, compared to 3.00 ± 1.77 for Group B, and 4.85 ± 1.81 for Group A. At 12 h, IL-6 levels hours were 2.66 ± 0.04 pg/mL for Group A, 2.39 ± 0.02 pg/mL for Group B, and 2.05 ± 0.01 pg/mL for Group C. At 6 h, CRP levels were 1.18 ± 0.04 mg/L for Group A, 0.95 ± 0.01 mg/L for Group B, and 0.70 ± 0.02 mg/L for Group C. Overall, Group C showed the lowest values for all parameters analyzed, compared with other groups, and the differences were significant (p < 0.05). In addition, none of the patients in Group C required rescue fentanyl (p < 0.05), and no patients in any of the groups showed any side effects. CONCLUSION: For pain management after C-section surgery, the combination of 750 mg paracetamol and 800 mg ibuprofen yielded the best results as assessed by NRS scores, levels of IL-6 and CRP, and fentanyl rescue.

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Socioeconomic, geographic and health system factors associated with rising C-section rate in Indonesia: a cross-sectional study using the Indonesian demographic and health surveys from 1998 to 2017

Cited by 13 publications

References 23 publications

Highest economic status increases risk of cesarean section in women of childbearing age

Highest economic status increases risk of cesarean section in women of childbearing age

The Effect of Pelvic Rocking Exercise with a Birth Ball and SP6 Acupressure on Duration of the First and Second Stage of Labor

Comparison of Pain Control and Inflammatory Profile in Cesarean Section Patients Treated with Multimodal Analgesia Utilizing Paracetamol and Ibuprofen

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