Beyond Physicians: Social and Familial Norms Driving Cesarean Section Decisions in Bangladesh

TL;DR

This study investigates how social and familial norms significantly influence the high cesarean section rates in Bangladesh, often overriding women's initial preferences and physician advice, highlighting socio-cultural factors in medical decision-making.

Contribution

It identifies the dominant role of social and familial norms over medical advice in cesarean decisions, using behavioral models to analyze socio-cultural influences.

Findings

91% of CS cases occurred against women's initial preferences

Family influence and social expectations are key drivers of CS decisions

Cesarean rates exceed WHO recommendations, driven by socio-cultural norms

Abstract

Women's health in Bangladesh faces risks due to an alarming rise in cesarean section (CS) rates, exceeding 72% in hospital-based deliveries, far surpassing the WHO's recommended limit of 15%. This study, guided by the Health Belief Model (HBM) and the Theory of Planned Behavior (TPB), explored socio-cultural factors influencing childbirth mode decisions. Among 503 survey participants, 91% of CS cases occurred against initial preferences, revealing a disconnect between health beliefs and behavior. Subjective norms, particularly family influence and social expectations, emerged as more critical in shaping CS decisions than physician recommendations.