Forecasting caesarean section births among pregnant women attending a teaching hospital in Osun, Nigeria

Background/Aims Both globally and in Nigeria, the incidence of caesarean section births has increased, prompting the need for in-depth investigation. This study's aim was to forecast the occurrence of caesarean section births in Osun, Nigeria, with a primary focus on examining contributing factors. Methods This retrospective cross-sectional study was conducted between February and December 2023, using questionnaires to collect data from 754 pregnant women who attended a teaching hospital in Osun, Nigeria and had a caesarean section. The Box-Jenkins method and predictive modelling were used to analyse the data. Results Neonatal mortality was higher among babies born to unbooked women compared to those born to booked women, meaning women who were registered during their pregnancy to have a caesarean section in case of an emergency. A notable prevalence of caesarean section births was observed in women who had previously had a caesarean section. The predictive models underscored that pre- and post-term pregnancies had notably higher probabilities of culminating in caesarean section. The 5-year forecast indicated that most future women who had caesarean sections would be 25–30 years old and have a gestational age 35–40 weeks, potentially influenced by previous caesarean sections. Conclusions Maternal age and gestational age can influence the likelihood of giving birth via caesarean section. The rate of caesarean sections is likely to continue to increase, meaning that government policies should be developed at national and sub-national levels to provide clear guidelines for caesarean sections. Implications for practice Healthcare professionals should actively promote early booking at antenatal care and consistent follow-up. Timely interventions and individualised birth planning may reduce risks associated with pre- and post-term pregnancies. There is an urgent need for standardised, context-sensitive caesarean section guidelines at both national and sub-national levels in Nigeria. With most future caesarean sections projected among women aged 25–30 years, reproductive health programmes should tailor educational and clinical interventions to address the unique needs and risk profiles of this age group.