Adverse Maternal Outcome and Associated Factors Among Women Who Gave Birth Through Cesarean Section and Spontaneous Vaginal Delivery in Public Hospitals of Addis Ababa, Ethiopia: Comparative Cross‐Sectional Study

Background Pregnancy and delivery are common normal physiological phenomena that occur in women. Despite extensive intervention implemented by different stakeholders, a large number of pregnancies remain complicated with disastrous results. To minimize this problem, clinicians implement cesarean section (CS). But the World Health Organization complains that CS contributes to more deaths than giving any advantage. Therefore, this study aims to compare adverse maternal outcomes and assess factors affecting them among mothers who give birth through CS and spontaneous vaginal delivery (SVD). Methods A Hospital‐based comparative cross‐sectional study was carried out in four public hospitals of Addis Ababa from May 20 to June 5, 2023. Systematic sampling was used to select a total of 470 study participants. Binary logistic regression analysis was applied, and the strength of association was measured using the adjusted odds ratio (AOR) with a 95% confidence interval (CI). Result The proportion of adverse maternal outcomes among mothers from the SVD and CS groups was 28.9% and 41.3%, respectively. Mothers who gave birth through CS experienced adverse outcomes two times (AOR = 1.95; 95% CI: 1.28–2.99) more likely than those who gave birth through SVD. For mothers from the CS group, mothers with previous pregnancy‐related complications (AOR = 2.61; 95% CI: 1.17–5.79), have a history of CS (AOR = 2.43; 95% CI: 1.21–4.86), current obstetric problem (AOR = 6.95; 95% CI: 3.28–14.71), and antepartum hemorrhage (APH) (AOR = 5.297; 95% CI: 1.35–20.81) were more likely to have an adverse outcome. For mothers from the SVD group, have a history of hemorrhage (AOR = 3.78; 95% CI: 1.08–13.20), prolonged duration of labor AOR = 3.71 : 1.19, 11.54, and having current obstetric problem (AOR = 2.08; 95% CI: 1.12–3.85) were significantly associated with adverse maternal outcome. Conclusion Women undergoing cesarean delivery had an increased risk of adverse maternal outcomes following delivery compared with women undergoing vaginal delivery (VD). The main independent variable, which is the mode of delivery, was significantly associated with adverse maternal outcomes. Therefore, health professionals working in maternal care, before doing a CS, should confirm the presence of a clear and sound indication.