Upsurge of caesarean sections in Pakistan: A qualitative study on perceptions of women and gynaecologists

Abstract Background: The upsurge of caesarean sections in Pakistan has become a matter of concern for public health. The current rate of caesarean sections has reached 19.6% of total childbirths in Pakistan. This study attempts to explore the perceptions of married women and gynaecologists about different social and cultural aspects affecting the upsurge of caesarean sections in Pakistan. Methods: In-depth interviews were conducted with pregnant women, women who already have given birth via caesarean section and gynaecologists in the leading public and private maternity hospitals located in Lahore, Pakistan. Qualitative data collected was analysed using thematic content analysis technique.Results: Major findings of the study revealed that the personal experience of previous caesarean section, experiences shared by other women, caesarean sections as a family trend, caesarean sections as a status symbol, fears related to vaginal childbirth, and lack of awareness about modes of childbirth are the most significant social and cultural aspects contributing to the upsurge of caesarean sections in Pakistan.Conclusion: Caesarean sections as a symbol of higher socio-economic status and the fear of prolonged labour during vaginal childbirth are the two key reasons to prefer caesarean sections. There is a need to create awareness among women about coping skills to deal with the fear and anxiety related to vaginal birth in order to improve the overall maternal health in Pakistan.