Approaches to optimize the unnecessary caesarean section in Bangladesh

This is the authors' abstract. We don't add key points for this paper.

In cases where vaginal delivery is not feasible and the mother's or the child's health is in danger, a Caesarean section (CS) is medically warranted. The World Health Organization (WHO) projects that between 10% and 15% of all births will have medically justifiable CS rates. Globally, WHO estimates that 6.2 million CSs are performed each year without medical justification. The determination to proceed with or forgo a CS can be understood as the result of weighing three key categories of influence: demand-side factors, supply-side factors, and clinical factors. Each of these categories contributes uniquely to the ultimate decision of whether to perform a CS, highlighting the multifaceted nature of this healthcare challenge. Within each input, there is also, often, a complex interplay. For example, there is a local narrative of mothers seeking an elective CS being "too posh to push", inextricably linking household socioeconomic factors and maternal preferences. On the supply side there are issues of the policy within the healthcare facility (private hospitals prefer CSs) and an interplay with time management and maximizing the efficiency of the facility. Bangladesh's CS has been on the rise; according to the most recent survey, it was 45%, far higher than the WHO recommendation. The private sector interacts with the high rates of CS in Bangladesh; MOH Bangladesh has little control over this sector. To optimize the CS rate, the nation must first recognize that needless CS is an issue and take all necessary action to address it.