The Factors Influencing Cesarean - Section Rates - A Narrative Review from Pakistan

Abstract

The significant increase in the rate of cesarean section is a major public health issue. The World Health Organization recommends C-section rates not to be greater than 10% and not lower than 5% as both the indicated limits can adversely affect maternal and newborn health. The rate of C-section deliveries is 22% according to recent Pakistan demographics and Health Survey of 2017-2018. This study contributes to the existing literature by examining the factors influencing high C-section rates in Pakistan. A narrative review of published literature between 2000 to 2020, on “factors influencing C-section rates in Pakistan” was done. The findings highlighted five factors that primarily influence utilization of C-section which include: 1. Accessibility to utilize C-section, 2. Association of C-section rates with socioeconomic profile, 3. Elective C-section, 4. Medical conditions as a cause of C-section, 5. C-section as a source of business. Pakistan like other Low middle income countries (LMICs) is facing the increased disease burden on its week and fragile health system. The over utilization of C-section rates has imposed additional burden on the health care system of Pakistan as well as increased economic and health resource liability on maternal care.