Determinants of Caesarean Section Delivery Among Mothers: Evidence from a Cross-Sectional Study in a Private Maternity Hospital in Medan, Indonesia

Abstract

The increasing rate of Caesarean Section (CS) delivery has become a global concern, particularly in private healthcare settings where non-medical factors may influence decision-making. Understanding maternal determinants is essential to optimize delivery practices and reduce unnecessary procedures. Objectives: This study aimed to identify maternal factors associated with CS delivery among mothers in a private maternity hospital in Medan. Methods: A cross-sectional study was conducted using secondary data from medical records of 341 mothers who delivered at RSU Bunda Thamrin between January and December 2025. The dependent variable was CS, while independent variables included maternal age, gestational age, history of CS, preeclampsia, and premature rupture of membranes (PROM). Data were analyzed using Chi-square tests and multiple logistic regression to determine adjusted odds ratios (aORs) with 95% confidence intervals (CIs). Results: A history of previous CS was the strongest predictor of CS (aOR=19.689; 95% CI: 2.589–149.737; p=0.004). Preeclampsia (aOR=5.396; 95% CI: 2.276–12.790; p<0.001) and PROM (aOR=9.005; 95% CI: 3.506–23.128; p<0.001) were also significantly associated with increased CS likelihood. Maternal age and gestational age showed no significant association. Conclusion: Clinical maternal complications, particularly previous CS, preeclampsia, and PROM, are key determinants of CS delivery. Strengthening antenatal care and risk-based management is essential to reduce unnecessary CS and improve maternal outcomes.