Investigating factors affecting the increase in cesarean section rates in primiparity women

Caesarean section (CS) in primiparity women is considered one of the important indicators in childbirth care. It is necessary to adopt effective strategies to reduce CS in primiparity women to maintain the health of the mother and baby. This study was conducted to determine the effective factors on the increase of CS in primiparity women from the point of view of service providers.

This cross-sectional study was conducted using a stratified sampling method on 412 midwives and gynecologists working in public hospitals of Mashhad University of Medical Sciences in 2022. The data were collected using an electronic questionnaire developed by the researcher and analyzed with SPSS-22 statistical software and descriptive and inferential statistical tests at a significance level of P < 0.05.

The minimum age of primiparity women was 23 years, the maximum was 41 years, and their average age was 32.01 ± 4.66 years. From the point of view of gynecologists and midwifery personnel, factors influencing the increase in CS were, respectively: financial affairs, pregnant mothers, education and culturalization of natural childbirth, management and supervision of natural childbirth promotion program, and service providers.

Health policymakers should consider implementing evidence-based strategies to reduce unnecessary CSs. Policymakers should also consider adopting the World Health Organization classification as an internationally applicable CS classification system to monitor and compare the CS rate. Therefore, the development of evidence-based care about nonclinical interventions to reduce unnecessary CSs in primiparous women is recommended to health policymakers.