INDICATIONS FOR CAESAREAN SECTION DELIVERY IN THE NORTHERN REGION, GHANA

Abstract

Background: Caesarean section (CS) is an important maternal and reproductive health intervention routinely performed in complicated pregnancies for the purpose of saving the lives of mothers and babies where vaginal delivery is deemed to be life threatening. Sometimes it is carried by the request of a mother as a preferred choice of delivery for various reasons. Little efforts are made to investigate the drivers and impact of increased CS rates in Ghana’s healthcare facilities partially in the northern region. This multi-facility observational study sought to close the knowledge gap when it comes to CS delivery in the northern region by targeting three different facilities in the region. General objective: The study investigated the rates, indications and outcome of CS delivery in some selected health facilities offering obstetric services in the Northern Region, Ghana. Methods: Descriptive cross-sectional study design to explore the rates, indications and outcomes of caesarean section operations in three health facilities in northern region, Ghana. Results: The overall caesarean section delivery rates in the health facilities (study sites) were 23.5% (TTH), 7.6% (TCH) and 7.7% (SMH) respectively. There were 34.1% elective CS compared to 65.9% emergency CS deliveries. The mean age of the participants was 29 ± 0.55 years, with median age of 30 years, and a modal age group of 25 – 34 years (64.40%). The major indications for caesarean section delivery in this study in descending order of magnitude include; history of previous CS (35.3%), poor progress of labour (12.9%), foetal distress (12.4%) and multiple gestation (9.4%). Conclusion: Caesarean section delivery rates at the district health facility level in the northern region were within the 10.0 – 15.0% range recommended by the WHO, however, that from the tertiary hospital (TTH) was well above this range. The commonest obstetric indications for CS are previous CS, poor progress, foetal distress etc and the demographic indications were parity and advance maternal age. Single cephalic mothers with or without previous cs with less degree of distress should be targeted for trial of vaginal delivery.