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Indications for Cesarean Sections in Rural Nepal

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Abstract

Objective

Globally, cesarean section (CS) rate is close to 26 %. Nepal has a reported CS rate of 5 %, with huge differences in rural (3.5 %) and urban (15 %) areas. The aim of the study was to determine the rate and indications for CS in a remote hospital in a rural area of Nepal.

Methods

A one-year cross-sectional prospective study from August 2014 to August 2015 was performed at Okhaldhunga Community Hospital (OCH). Semi-structured interviews of all women undergoing CS (91) were done, partly with the assistance of a local translator. A maternal waiting home is connected to the hospital.

Results

Out of the 864 births in the hospital, 91 CS were performed giving a CS rate of 9.5 %. The most frequent indications were: prolonged labor in 24 CS (26.4 %), abnormal fetal lie in 23 CS (25.3 %) and fetal distress in 18 CS (19.8 %). Three-quarters of CS were performed as an emergency. Almost half of the women stayed in the maternal waiting home prior to birth.

Conclusion

The CS rate at OCH was relatively low, within WHO’s recommendation, with types of indication similar to other countries. There were no signs of CS overuse. Maternal request was not the sole indication in any CS.

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Acknowledgments

The authors L.J. Samdal and K. R. Steinsvik were supported economically by a Norwegian scholarship named Generalkonsul Tønder Bull og hustru Valborg Bulls legat til medisinsk forskning. The funding sources had no involvement in the study design; collection, analysis, or interpretation of data; in the writing of the article; or in the decision to submit it for publication.

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Authors and Affiliations

  1. Faculty of Medicine, University of Oslo, Klaus Torgårds vei 3, 0372, Oslo, Norway

    Live Johanne Samdal, Kristina Reberg Steinsvik, Borghild Roald & Babill Stray-Pedersen

  2. Okhaldhunga Community Hospital, Okhaldhunga, 56100, Nepal

    Prakash Pun, Phanindra Dani & Erik Bøhler

Authors
  1. Live Johanne Samdal
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  2. Kristina Reberg Steinsvik
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  3. Prakash Pun
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  4. Phanindra Dani
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  7. Erik Bøhler
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Corresponding author

Correspondence to Live Johanne Samdal.

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Conflict of interest

The authors declare that there are no conflicts of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Animal and Human Rights

This article does not contain any studies with animal subjects.

Additional information

Live Johanne Samdal is a medical student in Faculty of Medicine at University of Oslo, Oslo, Norway; Kristina Reberg Steinsvik is a medical student in Faculty of Medicine at University of Oslo, Oslo, Norway; Prakash Pun, M.D., at Okhaldhunga Community Hospital in Okhaldhunga, Nepal; Phanindra Dani, Hospital Pharmacist, at Okhaldhunga Community Hospital in Okhaldhunga, Nepal; Borghild Roald, prof. dr. med, in Faculty of Medicine at University of Oslo, Oslo, Norway; Babill Stray-Pedersen, prof. dr. med., in Faculty of Medicine at University of Oslo, Oslo, Norway; Erik Bøhler, M.D., at Okhaldhunga Community Hospital in Okhaldhunga, Nepal.

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Samdal, L.J., Steinsvik, K.R., Pun, P. et al. Indications for Cesarean Sections in Rural Nepal. J Obstet Gynecol India 66 (Suppl 1), 284–288 (2016). https://doi.org/10.1007/s13224-016-0890-2

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  • DOI: https://doi.org/10.1007/s13224-016-0890-2

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