Factors associated with primary cesarean section delivery among women who gave birth at Wolaita Sodo University comprehensive specialized hospital, Southern Ethiopia

A cesarean section can be a crucial medical intervention when necessary. The primary cesarean section has become a major factor contributing to the increasing rate of cesarean section deliveries globally, especially in developing countries like Ethiopia. Therefore this study aimed to identify prevalence and factors that influence primary cesarean section delivery. The facility-based cross-sectional study was conducted at Wolaita Sodo University comprehensive and specialized hospital from June 10 to September 10, 2024. Systematic sampling method used to collect 403 sampled populations. Data were entered into EpiData version 4.6 and then exported to Statistical package of software for social science (SPSS) version 27 for analysis. Both bivariable and multivariable logistic regressions were used to assess the associations. The occurrence of multicollinearity was checked for the final model. Hosmer and Lemeshow's goodness-of-fit test with a large p value (p>0.05) was checked to see good model fitness. Only variables with p < 0.05 were reserved in the final model. A total of 392 participants with 97.3% response rate, the prevalence of primary cesarean section delivery were 28.57% (95% CI (21.2-36.4)). The primigravida mothers (adjusted odds ratio (AOR) 2.820 with 95% confidence interval (CI): (1.058-7.521)), fetal distress (AOR= 95% CI: 3.352(1.133-9.922)), and mothers with fetal macrosomia (AOR=95% CI: 6.325(1.714-13.271)) were more likely to undergo cesarean section. The utilization of the partograph during labor is negatively associated with primary cesarean section (AOR=95% CI: 0.301(0.131-0.691)). The likelihood of a primary cesarean section delivery is significantly higher in women with fetal distress, primigravida, and fetal macrosomia. However, the use of the partograph reduces unnecessary cesarean section deliveries, lowers associated risks, and improves outcomes. Therefore health facility should experience on partograph utilization. Pregnant women should start antenatal visit early and encouraged to deliver at health facility.