Prevalence of emergency caesarean delivery and its predictors among women who give birth in Ethiopia using further analysis of EDHS 2016 data: A mixed effect model

Abstract

Introduction Emergency caesarean delivery is a surgical procedure that is decided after the labour pain has started. According to the global report of the World Health Organization, the rate of caesarean sections has risen over time. In Ethiopia, the overall caesarean delivery was 18%, which varied between 46% in the private sector and 15% in the public sector. But specifically, the magnitude of emergency caesarean delivery and its predictors are not well addressed in Ethiopia. Therefore, this study was aimed at assessing the prevalence and predictors of emergency caesarean delivery in Ethiopia using EDHS 2016. Method A cross-sectional study was used, and a total of 11,022 samples were included in this study. The Ethiopian Demographic Health Survey 2016 data set was used as a data source. The STATA version 17 software was used for descriptive, bi-variable, and multivariable analysis. Multilevel binary logistic regression was used to identify the significant factors at a p-value of <0.05 and a 95% confidence level. Model comparison and goodness of fit was assessed by AIC. Results The prevalence of emergency caesarean deliveries in Ethiopia was 1.2% (95% CI: 0.58, 1.78). History of fistula (AOR = 7.82, 95% CI: 1.59–38.4), age ≥ 35 years (AOR = 6.98, 95% CI: 3.33–14.63), and rural residence (AOR = 2.23, 95% CI: 1.25–3.21) were the predictors of emergency caesarean delivery. Conclusion As compared to the previous study, the prevalence of emergency caesarean delivery was low. Women with a history of fistula, from rural residence, and age≥ 35 years were at risk for emergency caesarean delivery. Therefore, interventions need to be encouraged to give attention to rural women whose age is ≥ 35 years and fistula reduction activities, such as avoiding early marriage, to reverse the problem. Early and accurate screening of women for emergency cesarean delivery by encouraging co-services like ANC is also recommended.