Dawit Mekonnen Alemu, Mahlet Yigeremu, Dawit Desalegn, Hailemariam Mekonnen Tizazu, Firaol Niftalem Temesgen and Yidersal Demsie Denberu
Background: The rate of cesarean sections (CS) has increased worldwide, including in low-, middle-, and high-income countries, driven by advances in obstetric care and safer surgical procedures. In Ethiopia, the national CS rate rose from 0.7% in 2000 to 1.9% in 2016, with increases reported in seven out of eleven administrative regions. Studies from public hospitals in Addis Ababa show CS rates ranging from 21% to 38%. (4,6). Despite this rise, no data exists on the prevalence of primary cesarean sections—those performed on women giving birth for the first time or who have never had a CS before. Reducing primary CS rates is crucial, as recommended by the American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine, which advocate for strategies that ensure safe delivery practices.
Objectives: To assess the magnitude and factors associated with primary cesarean sections among women who gave birth at 37 weeks or later in three teaching hospitals of Addis Ababa University, Ethiopia.
Methods: A hospital-based cross-sectional study was conducted from January to April 2024. Systematic random sampling selected 422 participants, and data were analyzed using SPSS version 23.
Results: Among 422 mothers, 25.83% underwent primary CS. The most common reasons were fetal distress (55%), malpresentation (19.3%), failed induction (11.9%), and cephalopelvic disproportion (11%). Factors significantly associated with primary CS included parity, gestational diabetes, chronic medical conditions, fetal presentation, membrane status, and amniotic fluid status (p < 0.05).
Conclusion: High primary CS prevalence highlights the need for improved management of chronic conditions and labor monitoring to reduce unnecessary procedures while ensuring maternal and neonatal safet