An Uninformed Decision-Making Process for Cesarean Section: A Qualitative Exploratory Study among the Slum Residents of Dhaka City, Bangladesh
Open accessAbstract
The decision-making process and the information flow from physicians to patients regarding deliveries through cesarean section (C-section) has not been adequately explored in Bangladeshi context. Here, we aimed to explore the extent of information received by mothers and their family members and their involvement in the decision-making process. We conducted a qualitative exploratory study in four urban slums of Dhaka city among purposively selected mothers (n = 7), who had a cesarean birth within one-year preceding data collection, and their family members (n = 12). In most cases, physicians were the primary decision-makers for C-sections. At the household level, pregnant women were excluded from some crucial steps of the decision-making process and information asymmetry was prevalent. All interviewed pregnant women attended at least one antenatal care visit; however, they neither received detailed information regarding C-sections nor attended any counseling session regarding decisions around delivery type. In some cases, pregnant women and their family members did not ask health care providers for detailed information about C-sections. Most seemed to perceive C-sections as risk-free procedures. Future research could explore the best ways to provide C-section-related information to pregnant women during the antenatal period and develop interventions to promote shared decision-making for C-sections in urban Bangladeshi slums.
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Research related to C-section deliveries among women in urban informal settlements and the reasons thereof has been limited.
“Research related to C-section deliveries among women in urban informal settlements and the reasons thereof has, however, been limited”
From "Everywhere you see, C-sections are happening": examining trends and reasons for a rise in cesarean-section deliveries among women in urban informal settlements, Mumbai Metropolitan Region, using a mixed methods approach (2026) · cites this paper as [24]
The Introduction (page not available) says there is little evidence in Bangladesh about whether decisions to have C-sections are shared, and the study examines that process among Dhaka slum residents. This supports a narrower research gap than the claim: the paper does not say that research on C-section deliveries and their reasons in urban informal settlements is generally limited. (LLM, conf=0.83)
Experimental — accuracy not yet measuredA fractured patient-practitioner relationship ultimately led to negative C-section experiences, maintaining a stigma surrounding C-sections and contributing to C-section deliveries.
“A fractured patient-practitioner relationship, as seen in other LMIC contexts as well [24, 31, 34], ultimately led to negative C-section experiences, maintaining a stigma surrounding C-sections and contributing to C-section deliveries.”
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Additional file 1 of Variation of caesarean section rates in Palestinian governmental hospitals
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Additional file 2 of Variation of caesarean section rates in Palestinian governmental hospitals
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Self-citation
- Authors
- Sultana, J., Sutradhar, I., Rahman, M. J., Khan, A. N. S., Chowdhury, M. A. K., Hasib, E., Chhetri, C., Mahmud, S. M. H., Kashem, T., Kumar, S., Myint, Z. T., Rahman, M., Huda, T. M. N., Arifeen, S. E., & Billah, S. M.
- Affiliations
- International Centre for Diarrhoeal Disease Research (BD)
- BRAC (BD)
- Johns Hopkins University (US)
- Family Health International, Dhaka 1212, Bangladesh
- Falck Global Assistance, Gurugram 122015, India
- Bangladesh National Nutrition Council, Mohakhali, Dhaka 1212, Bangladesh
- Bangladesh Palliative and Supportive Care Foundation, Dhaka 1212, Bangladesh
- Health Systems Transformation Platform, New Delhi 110070, India
- Community Partners (US)
- The University of Sydney (AU)
- Corresponding author
- Sultana, Jesmin
- ORCID
- Venue
- International Journal of Environmental Research and Public Health
- Publisher
- MDPI AG
- Published
- 2022-01-27
- Volume
- 19
- Issue
- 3
- Pages
- 1465
- ISSN
- 1660-4601 (ISSN-L)
- PMC
- PMC8835678
- OpenAlex
- W4210713368
- Cited by
- 16
- References
- 44
- Citations by year
- 2026: 6 · 2025: 3 · 2024: 3 · 2023: 2 · 2022: 2
- FWCI
- 2.51
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- International Journal of Environmental Research and Public Health (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Funders
- BRAC James P. Grant School of Public Health, BRAC University, Dhaka, Bangladesh (N/A)
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
- Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Health and Contraception
- Keywords
- cesarean section, shared decision-making, physician-patient communication, information asymmetry, maternal decision-making, prenatal care, urban slums, Dhaka, pregnant women
- MeSH terms
- Bangladesh, Cesarean Section, Decision Making, Female, Humans, Poverty Areas, Pregnancy, Qualitative Research, Pregnant People, Pregnant Women
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