Exploring the factors influencing repeated C-section deliveries in India: insights from the National Family Health Survey 2019–21

“Once a Caesarean, always a Caesarean,” according to the World Health Organisation (WHO), a caesarean section is a surgical procedure that can save the life of a woman and her baby when undertaken for medical reasons. With this backdrop, the goal of this study is to identify the prevalence of repeated C-section deliveries and the factors related to increased C-section deliveries by type of institution. This study used a nationally representative sample from the fifth round of the National Family Health Survey (2019–21). The study includes 5965 respondents who had a repeated C-sections among the 7760 births. Univariate and bivariate analysis was performed for the level of repeated C-sections, and binary logistic regression was performed to determine the influencing factors of caesarean deliveries. The 78% birth delivered by the repeated C-section, where 79% in private hospitals followed by 76 in public health care facilities. Sikkim and Telangana have the highest level of repeated C-sections, whereas Meghalaya, Ladakh, and Assam have the lowest repeated C-sections deliveries. For public facilities, Kerala has the highest and Bihar has the lowest level of repeated C-section deliveries; Sikkim, Goa, and Telangana have the highest, and Meghalaya. The regression results show that mothers age greater than 35 years were [AOR = 1.918, 95% CI (1.076 3.42)], the wealthiest women had the highest odds [AOR = 1.775, 95% CI (1.397 2.256)], women who had undergone ultrasonography were significantly [AOR = 1.469, 95% CI (1.16 1.861)], were more likely to be delivered by repeat C-section than their counterpart. The findings of this study suggest that repeated C-section deliveries in India have been significantly decreased in India, and private facilities play a significant role in repeated C-sections as compared to public facilities of delivery. The study recommended that the doctors prioritize normal delivery procedures at the first stage and then only control repeated C-section delivery.