Factors Associated with Emergency Caesarean Section when Compared to Elective Caesarean Section

Background: The global prevalence of caesarean section (CS) is estimated to be 21.0%, and ranges between 16.5% and 26.9% in Ghana. Delivery by CS can be either emergency or elective, with prevalences of 4.6% and 3.4%, respectively, in Sub-Saharan Africa. The maternal, foetal, and neonatal factors associated with emergency and elective CS are varied but may markedly overlap due to the use of normal vaginal delivery as the reference group in previous studies. This study aims to determine the factors associated with emergency CS using elective CS as the reference group. Methods: This cross-sectional study was conducted between January 1, 2024, and May 31, 2025, among women aged 18 to 47 years at the Akyem Oda Government Hospital in Ghana. Only pregnant women who delivered by caesarean section and were above 18 years were included in the study. Sociodemographic, anthropometric, and obstetric data were collected using a semi-structured questionnaire and from medical records. The differences in data distribution between the groups were determined using independent bivariate analysis. Factors associated with emergency CS were determined using logistic regression analysis. All analyses were two-sided, and statistical significance was considered at a P-value < 0.050. Results: The study involved 235 women, of whom 166 (70.6%) gave birth by emergency CS, while the rest, 69 (29.4%), gave birth by elective CS. It was observed that birth weight < 3.5 kg [AOR = 0.413(95% CI: 0.196–0.869)] was inversely associated with emergency CS. However, maternal factors were about three times more likely to be associated with emergency CS than neonatal factors [AOR = 3.064 (95% CI: 1.444–6.498)]. Conclusion: Emergency and elective CS may have overlapping determinants; however, the birth weight of less than 3.5 kg is inversely associated with emergency CS, while maternal factors are positively associated with emergency CS.