Socioeconomic roles in cesarean section delivery in the philippines: A secondary analysis of the 2022 national demographic and health survey

Background: Cesarean section (CS) delivery should only be performed when medically indicated. However, socioeconomic disparities continue to influence CS utilization in many countries, including the Philippines. Although previous studies have examined CS rates, there is limited evidence, based on the latest national data, on how socioeconomic factors shape CS use in the Philippines. Purpose: This study aimed to analyze the socioeconomic roles in CS delivery in the Philippines. Methods: This study used secondary data from the 2022 Philippines National Demographic and Health Survey (NDHS). The cross-sectional study included 4,452 women aged 15-49 who had given birth within the previous three years. Seven control factors were examined: Employment, antenatal care (ANC), age, education, marital status, residence, and parity. The mode of delivery was considered the outcome variable, while socioeconomic status was the exposure variable. Binary logistic regression was used for the final data analysis. Results: CS was performed in 18.45% of deliveries in the Philippines. Analysis of socioeconomic status indicated that women in the poorer group were 1.758 times more likely than those in the poorest group to undergo CS (AOR 1.758; 95% CI 1.757-1.758). Women in the middle group were 2.164 times more likely than the poorest to have a CS (AOR 2.164; 95% CI 2.163-2.165). Those in the richer group were 2.718 times more likely (AOR 2.718; 95% CI 2.717-2.719), and those in the richest group were 4.787 times more likely (AOR 4.787; 95% CI 4.785-4.789) to deliver by CS compared with the poorest. Conclusion: Socioeconomic disparities are strongly associated with CS delivery in the Philippines. The wealthier the mother, the more likely she is to have a CS. ANC education should be optimized by addressing psychological needs, promoting positive values, and providing a sense of security and comfort in normal childbirth. At the same time, equitable access to CS should be ensured for the poorest groups through education and insurance coverage.