Determinants of Mode of Delivery: A Cross Sectional Analysis of Maternal and Health System Factors

Abstract

Background: Pregnancy and childbirth are important events in a woman’s life. The method of delivery is mainly dependent on maternal or provider preferences. Childbirth may occur through various delivery methods. There are factors that determine the choice of mode of delivery for every pregnant woman. These factors are dependent on: The Age of the woman, Parity, past Obstetric history, previous cesarean section, Co-morbidities, Lie and presentation of the fetus, Placental location, Fetal weight/Size, Congenital anomalies of the fetus, Structure of maternal pelvis, mode of Conception, Social/Religious and Cultural beliefs and Maternal request. The mode of delivery has an impact on the childbirth experience for each woman. Mode of delivery may also affect pregnancy outcome. Objective: The aim of this study is to highlight the determinants of mode of delivery. A good knowledge of them, will help to prevent most adverse effects associated with childbirth. Method/ Materials: This was a retrospective cross-sectional study of 9538 women, ages 16yrs-48yrs who delivered in our facility between January 2019- December 2023. The choice of mode of delivery was usually determined by medical personnel who took care of the woman during her ante-natal visits, or by the patient herself. These choices are made based on certain factors as earlier mentioned with the aim of achieving satisfactory outcome for the mother and her fetus. Results: Spontaneous vaginal delivery was the highest mode of delivery (4975) 52.28%. This was followed by cesarean section (CS) (4000)41.93%.  The high rate of CS was because our facility was a referral center for complicated cases in other health facilities in the state, thus not a good reflection of the general CS rate The highest indication for CS was 2 previous cesarean section.(24.7%) Conclusion: The declining utilization of Forceps delivery, due to lack of skill, has contributed to increasing rate of cesarean section.