Prevalence and Determinants of Cesarean Section Deliveries in a Tertiary Hospital in Southwest Ethiopia

Background: Cesarean section (CS) is a critical intervention in obstetric care, but its increasing rate and associated maternal outcomes have raised concerns worldwide, especially in resource-limited settings. This study assessed the prevalence, indications, outcomes, and associated factors of CS deliveries at Mizan-Tepi University Teaching Hospital in Southwest Ethiopia. Methods: A retrospective cross-sectional study was conducted among 330 women who delivered at the hospital. Sociodemographic data, obstetric history, type and indication of CS, and maternal outcomes were extracted from patient records. Bivariate and multivariate logistic regression analyses were used to identify factors associated with CS and maternal complications, with a significance threshold of p < 0.05. Results: The CS rate was 25.8%, exceeding the WHO-recommended threshold of 15%. Most CS procedures (84.7%) were emergency operations. Nonreassuring fetal heart rate patterns were the leading indication (28.2%). Compared with multigravidarum women, primigravidarum women were nearly twice as likely to be delivered by CS (AOR = 1.94; 95% CI: 1.13–3.34). Women in labor for more than 12 hours were significantly more likely to undergo CS (AOR = 0.32; 95% CI: 0.19–0.55). The most common maternal complications following CS were infection (34.1%) and postpartum hemorrhage (11.8%). A preoperative hemoglobin level of < 10 g/dL was strongly associated with postoperative complications (AOR = 87.9; 95% CI: 8.87–871.28), as was a prolonged duration of membrane rupture (> 12 hours) (AOR = 0.036; 95% CI: 0.004–0.299). Conclusion: The cesarean section rate at Mizan-Tepi University Teaching Hospital is higher than the WHO recommendation. Prolonged labor, primigravidity, anemia, and prolonged membrane rupture are key risk factors for CS and its complications. Improved antenatal care, timely referral, and labor monitoring are essential to reduce unnecessary CS and associated maternal morbidity.