Authors
1 Health Economist, Health Management and Economics Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
2 Associate Professor, Epidemiology and Statistics, Isfahan University of Medical Sciences, Isfahan, Iran
3 Lecturer, Midwife, Rafsanjan University of Medical Sciences, Rafsanjan, Iran And PhD Student, Student Research Committee, Fertility Health, Isfahan University of Medical Sciences, Isfahan, Iran
4 BSc, Midwife, Teaching and Therapeutics Centre of Niknafs Teaching Center, Rafsanjan, Iran
Abstract
Introduction: In the last decades, the increased rate of cesarean section has challenged its
primary goals seriously. Many researchers showed the positive relationship between
socioeconomic status and prevalence of cesarean delivery. However, it seems that the prevalence
of elective cesarean is increasing in low socioeconomic classes, too. The aim of this study was to
evaluate the relationship between socioeconomic status and the prevalence of elective cesarean in
nulliparous women in Niknafs Teaching Centre, Rafsanjan, Iran.
Methods: This cross-sectional study was carried out in Niknafs Teaching Center, Rafsanjan, Iran
during 8 months. A total number of 459 nulliparous women registered in the study. A valid
questionnaire was completed during a short time interview with the subjects. It included the
demographic, economic, and educational status of the subjects as well as information about the
delivery type. The collected data was analyzed using chi-square and Fisher's exact tests in
SPSS16.
Results: Five socioeconomic groups were defined as very poor, poor, fair, good, and very good.
Overall, 74% of the subjects were placed in fair and lower groups. Significant relations were
observed between socioeconomic status and primary elective cesarean delivery (P < 0.001) and
also the final rate of cesarean delivery (P = 0.02). However, there was no statistically significant
relationship between the reason of cesarean delivery and socioeconomic classes of the mothers.
Conclusion: The improvement of socioeconomic status of the subjects showed a linear
relationship with increased demand for elective cesarean delivery. However, this type of cesarean
was also commoner than standard rates in low socioeconomic classes. This rate could impose lots
of financial pressure to the health system and could be considered as a cause of inefficiency in the
health care delivery system.
Keywords