ArticlePloS one2019
Monitoring caesarean births using the Robson ten group classification system: A cross-sectional survey of private for-profit facilities in urban Bangladesh.
Article in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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17 citing papers in PubMed, 32 citations in OpenAlex.
- The cesarean epidemic in Bangladesh: Associated factors and maternal health risks.Journal of public health research · 2026Article
- Factors behind high caesarean section in Bangladesh: insight from a systematic literature review and meta-synthesis.BMJ public health · 2026Article
- Re-Striking the Indications in the Improvement of Avoidable Caesarian Section: A Cluster Randomized Control Trial.Health science reports · 2025Article
- A Retrospective Analysis of the Robson Classification Implementation in a Tertiary Care Hospital in Serbia.Journal of clinical medicine · 2025Article
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- "I can't make it safe, so I don't do it": Exploring obstetricians' views on barriers and enablers to promoting vaginal birth after caesarean section in Bangladesh.PLOS global public health · 2024Article
- Maternal and perinatal outcomes of women with vaginal birth after cesarean section compared to repeat cesarean birth in select South Asian and Latin American settings of the global network for women's and children's health research.Maternal health, neonatology and perinatology · 2023Article
- Frequency of Caesarean Section Classified by Robson's Ten Group Classification System: A Scoping Review.Cureus · 2023Article
- Robson classification of caesarean births: implications for reducing caesarean section rate in a private tertiary hospital in Nigeria.BMC pregnancy and childbirth · 2023Article
- Cesarean section rate changes after audit and feedback with the Ten Group Classification System in a French perinatal network: A retrospective pre-post study.Acta obstetricia et gynecologica Scandinavica · 2022Article
- Robson's Group 2 Criteria among Total Caesarean Sections in a Tertiary Care Hospital: A Descriptive Cross-sectional Study.JNMA; journal of the Nepal Medical Association · 2021Article
- Prevalence and factors associated with skin-to-skin contact (SSC) practice: findings from a population-based cross-sectional survey in 10 selected districts of Bangladesh.BMC pregnancy and childbirth · 2021Article
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- Prevalence, Indications, and Community Perceptions of Caesarean Section Delivery in Ngora District, Eastern Uganda: Mixed Method Study.Obstetrics and gynecology international · 2020Article
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Authors and funding
6 authors at 4 institutions in 3 countries.
Funding
Abstract
backgroundGlobally, Caesarean section (CS) rates are mounting and currently exceed the safe upper limit of 15%. Monitoring CS rates using clinical indications and obstetric sub-group analysis could confirm that women in need have been served. In Bangladesh, the reported CS rate was 31% in 2016, and almost twice that rate in urban settings. Delivering in the private healthcare sector was a strong determinant. This study uses Robson Ten Group Classification System (TGCS) to report CS rates in urban Bangladesh. The clinical causes and determining factors for CS births have also been examined.
methodsThis record linkage cross-sectional survey was undertaken in 34 urban for-profit private hospitals having CS facilities during the period June to August 2015. Data were supplied by inpatient case records and operation theatre registers. Descriptive analyses were performed to calculate the relative size of each group; the group-specific CS rate, and group contribution to total CS and overall CS rate. CS indications were grouped into eleven categories using ICD 10 codes. Binary logistic regression was performed to explore the determinants of CS.
resultsOut of 1307 births, delivery by CS occurred in 1077 (82%). Three obstetric groups contributed the most to overall CS rate: previous CS (24%), preterm (23%) and term elective groups (22%). The major clinical indications for CS were previous CS (35%), prolonged and obstructed labor (15%), fetal distress (11%) and amniotic fluid disorder (11%). Multiple gestation, non-cephalic presentation, previous bad obstetric history were positive predictors while oxytocin used for labour induction and increased parity were negative predictors of CS.
conclusionsAs the first ever study in urban private for-profit health facilities in Bangladesh, this study usefully identifies the burden of CS and where to intervene. Engagement of multiple stakeholders including the private sector is crucial in planning effective strategies for safe reduction of CS.
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