Beyond the Scar: A Qualitative Study on the Physical, Psychosocial and Economic Impacts of Caesarean Section in Keonjhar District of Odisha

Background According to World Health Organization (WHO), globally, there is an increasing rate of Cesarean section (CS) with 1 in 5(21%) deliveries, and it is expected to increase to 29% by 2030. While CS is lifesaving, it often imposes significant physical, psychological, and financial burdens on women. These impacts are particularly pronounced in rural and tribal populations, where access to adequate healthcare and support is limited. Thus, this study explores the multifaceted consequences of CS in Keonjhar district of Odisha focusing on physical recovery, psychosocial well-being, and economic strain. Methods The study used qualitative method of data collection during November to December 2024. A, semi-structured interview approach was used to gather in-depth accounts from 35 women who had recently undergone CS in Keonjhar District, Odisha. The information on CS deliveries were collected from public and private health care and the women were were traced who had delivered through CS in the last two weeks. Information on on physical recovery, emotional experiences, and economic challenges associated with CS. Data were collected and analyzed using MaxQDA 07 to identify recurring patterns and themes. Results The study revealed that women in Keonjhar faced significant physical pain and postoperative complications, such as delayed wound healing, infections, and anemia. Many struggled to resume household chores or fieldwork, exacerbating recovery. Psychosocial impacts included postpartum depression, feeling of regret and feelings of guilt, as many women believed that a vaginal birth was the ideal outcome. Financially, CS resulted in substantial out-of-pocket costs, including hospital fees, transportation, and follow-up care, leading many families into debt. These burdens were compounded by the lack of insurance and financial protection schemes. Conclusions The findings highlight the urgent need for improved postpartum care, particularly home visits by health workers to monitor recovery and provide mental health support. Additionally, integrating mental health screening and counselling into postpartum care can alleviate the emotional toll. To ensure holistic care, culturally sensitive, context-specific interventions are required to support women recovering from CS in rural areas of India.