A Retrospective Cohort Study of Pregnant Women in Labor at Kediri 1 Public Healthcare Center, Tabanan, Bali, Indonesia: A Focused Discussion on the Increasing Trends in Cesarean Section Deliveries

OBJECTIVE: The cesarean section (CS) is a surgical procedure in obstetrics that serves to protect the health and safety of both mothers and infants during labor process. Nevertheless, its prevalence has increased significantly in recent times. As such, this study aims to examine potential risk factors of expectant mothers in labor in Kediri 1 Public Healthcare Center, Tabanan, Bali, Indonesia. METHODS: A retrospective cohort study was carried out on 848 pregnant women who received antenatal care at Kediri 1 Public Healthcare Center in Tabanan. The study followed up on electronic cohorts and medical records to determine the birth outcomes. Univariate and multivariate analyses were conducted using SPSS statistical software version 27 to determine the relative risk (RR). RESULT: Most of women in labor are between 20-33 years old (75.4%) with mean age of 28.6 + 5.6. CS was the most common delivery method (67.9%), with obstetric indications being the most frequent reason (60.3%). Among these obstetric indications, LMR was the most common reason (49.3%). The study also revealed that maternal age and BMI were independent risk factors for CS aRR 1.89, 95% CI (1.19-2.99) p = 0.007 and aRR 2.18, 95% CI (1.01-4.70) p = 0.045, respectively. Additionally, maternal height was identified as a risk factor for CPD with an aRR of 8.39, 95% CI (2.36-29.8) p = 0.001. CONCLUSION: Several factors have led to the growing acceptance of cesarean sections, including scientific advancements, social and cultural transformations, and medicolegal considerations. However, it should be noted that this procedure entails risks for both the mother and the child, and therefore should only be carried out when it is deemed necessary and beneficial.