A recent study has revealed a rise in caesarean section deliveries among rural women in Rajshahi district, with one in three births now occurring through surgery — raising public health concerns over the growing reliance on surgical births.
Published in the international medical journal BMJ Open, the study surveyed 540 mothers across nine upazilas of Rajshahi and found that 34.4 per cent of deliveries were performed via C-section — a rate significantly above the World Health Organization’s recommended threshold.
The WHO recommends that C-section rates should not exceed 10 to 15 per cent unless medically justified.
According to the report, the majority of these operations — over 82 per cent — were conducted in private clinics, with only 17 per cent taking place in public hospitals.
Researchers from the University of Rajshahi, Rajshahi Medical College, and Varendra University conducted the study to assess maternal and pregnancy-related factors associated with caesarean deliveries in the region.
Professor Md Golam Hossain, the study’s lead author, said that there was an increasing trend in urban areas for C-sections for various reasons, including job pressure.
‘C-sections are becoming increasingly common even in rural areas,’ he said.
Health experts have long cautioned against the overuse of C-section, which should be reserved for high-risk pregnancies or medical emergencies.
The study, however, reveals that non-medical factors — particularly poor nutrition, lack of sleep, and insufficient prenatal care — are now strongly associated with surgical births in the region.
Women who reported consuming inadequate food during pregnancy were 1.65 times more likely to undergo C-section, while those with insufficient micronutrient intake had 1.78 times higher odds.
Sleep deprivation also emerged as a major predictor, as mothers who slept less than seven hours a day were 2.6 times more likely to deliver via C-section.
‘Caesarean delivery should not be a lifestyle choice or a consequence of poor maternal health,’ said Md Golam Hossain.
‘We found that factors like severe headaches with blurred vision and oedema — often linked to poor diet and rest — also contributed significantly to the rise in C-section rates,’ he added.
The study also found that women who had C-section deliveries were significantly more prone to developing complications such as obstetric fistulas and postpartum anaemia.
The study warns that rising C-section rates could place a growing burden on the country’s maternal healthcare system, particularly in underserved rural areas like Rajshahi.
With public hospitals accounting for only 17 per cent of C-section deliveries in the district, most women rely on costly private clinics.
Save the Children previously estimated that Bangladesh spent $483 million on unnecessary C-sections in a single year.
The researchers urge the government to take immediate action by strengthening antenatal counselling, regulating private health facilities, and raising awareness about the risks of unnecessary C-sections.
The report also recommends that health workers screen for warning signs during pregnancy — such as poor nutrition, swelling, and sleep deprivation.
