Application of Fuzzy PROMETHEE in the Analysis of Childbirth Techniques

Childbirth is a life-giving procedure whereby a whole individual is given an existence though at some points there may be a loss of infants along the journey. Maternal morbidity and death continue to be global issues despite improvements in contemporary obstetrics. This study aims at evaluating vaginal birth, emergency cesarean, elective cesarean, vaginal birth after C-section, vacuum extraction, and forceps delivery techniques considering the selected criteria which are the requirement of medical indication, patient preparation, the use of prophylactic antibiotics, infection rate, mortality rate, safety, prenatal hemorrhage, post-partum hemorrhage, laceration, use of general anesthesia, birth trauma, organ injury, dystocia, fetal distress, time of the procedure, cost, recovery, and the formation of long term scars using fuzzy Preference Ranking Organization Method for Enrichment Evaluations (fuzzy PROMETHEE); a multi-criteria decision-making (MCDM) model. The results of this study showed that vaginal birth was the first preferable ranked technique with a net outranking flow of 0.0773 and forceps delivery, vacuum extraction, vaginal birth after c-section, and emergency cesarean followed, with a net flow of $0.0195,0.0123$, $-0.0129,-0.0422$, respectively. The elective cesarean method was found to be the least preferable technique ranking sixth with a net flow of $\mathbf{- 0 . 0 5 4 0}$. Fuzzy PROMETHEE showed high effectiveness and accuracy in the ranking system. This method will support midwives, obstetricians, and mothers in deciding and weighing the risks associated with possible delivery approaches.