Skip to main content

Long-term effects of caesarean delivery on health and behavioural outcomes of the mother and child in Bangladesh

Abstract

Background

Medically unnecessary caesarean section (CS) is now an ongoing concern worldwide including in Bangladesh. This intensifies the occurrence of adverse maternal and child health outcomes. We investigated the associations of CS with some basic health and behavioural outcomes of the mothers and their children in Bangladesh.

Methods

We conducted a community-based case–control study from May to August 2019. A total of 600 mother–child dyads were interviewed using a structured questionnaire, 300 of them had CS, and 300 had vaginal delivery (VD) in their most recent live births. The exposure variable was the mode of delivery, classified as 1 if mothers had CS and 0 if mothers had VD. The outcome variables were a group of health and behavioural problems of the mothers and their children. Multivariate or multiple logistic regression model, separately for each health and behavioural outcome, was used to determine the effect of exposure variable on outcome variable after adjusting for possible confounders.

Results

The mean age and weight of mothers were 25.1 years and 53.1 kg, respectively. Likelihoods of headache, after delivery hip pain, problem of daily activities, and breastfeeding problem were reported higher among mothers who had CS in their most recent live birth than mothers who had VD. Similarly, children who were born through the CS operation were more likely to report breathing problem, frequent illness, lower food demand and lower hours of sleeping.

Conclusion

The use of CS increases the risks of health and behavioural problems of the mothers and their children. Policies and programs to avoid medically unnecessary CS and increase awareness over its adverse effects are important.

Background

Caesarean section (CS) is a surgical procedure in which a baby is delivered through an incision of the mother’s abdomen. Ideally, this is recommended when the Vaginal Delivery (VD) would put a baby and/or his/her mother at risk and would not be saved without performing the CS. The World Health Organization (WHO) in 2004 recommended an upper limit of CS use should be 15%, with a further recommendation of 1–5% CS use is enough to avoidable unnecessary morbidity and mortality of mothers and their children [1, 2]. However, the number of CS is increasing globally, starting in early 1990 [3]. Around 21% of the total current world’s births, ranging from 6% in low- and middle-income countries (LMICs) to 27% in developed region, are currently ended by CS [3]. At the regional level, the rate is higher in Eastern Asia (35%), Central America (38%), North America and Oceania (32%) [3, 4]. These rates would have been increased to around 50% by 2030 with a global prevalence of 29% CS- a recent projection found [4]. The reasons for these dramatic increases are multi-factorial and varied across countries’ socio-economic conditions. However, maternal demographic and reproductive characteristics, including higher age mothers at the time of pregnancy, higher birth order, lower inter-pregnancy interval, higher household wealth quintile and higher educational status of the mothers and their partners are found most influential factors of performing CS in Bangladesh as well as other LMICs [5,6,7]. Professional practice style of the health care personnel, including unethical practice to motivate mothers to undergo CS for making money, has recently been addressed as other important contributors to the rising rate of CS in LMICs [8,9,10]. Moreover, mothers’ homes distance from the nearest health care facility and quality and accessibility of the health care services available there are found as other important predictors of CS use in a recent study of Bangladesh [7].

There is evidence that the use of CS prevents nearly 187,000 maternal and 2.9 million neonatal deaths worldwide [4, 11]. However, along with these contributions in reducing maternal and child deaths, medically unnecessary CS can increase short- and long-term health risks of mothers and their children. The short-term risk includes infection, haemorrhage, visceral injury, placenta accrete, and placental abruption [12,13,14]. The long-term risk includes asthma and obesity [12]. Moreover, higher likelihoods of miscarriage, ectopic pregnancy, and stillbirths in the subsequent pregnancies are found among the mothers having CS [15,16,17,18,19,20]. Placental accrete, placental abruption, and uterine rupture are also found higher among mothers with a previous history of CS than VD [18, 21, 22]. However, the effects of CS on maternal and child physical and behavioural health problems following delivery have not been studied yet, in Bangladesh, as well as, in other LMICs. Therefore, in this study, an attempt has been made to examine the effects of CS on some basic physical and behavioural health problems of mothers and children. The findings of this study will inform the policymakers in making relevant policies and programs and will work as a basis for conducting relevant research in a larger setting in future.

Methods

Data collection

A community-based retrospective case–control study was conducted from May to August 2019. The study was conducted in seven communities of the Rajshahi District of Bangladesh, covering both the village and suburban area. Around 60,000 people live in our study area whereas the community health workers reported 2560 live births within three years before the survey was conducted as part of the immunization program. We used this list as the sampling frame. We first divided this list as per the delivery methods (CS vs. VD). Data were then collected from 600 mother–child dyads in total, covering an equal number of CS (n = 300) and VD (n = 300). Our included sample was three times higher than the standard sample size required for this study as determined using the standard formula for required sample size calculation [23]. The samples were selected randomly by using the list and continued up to the inclusion of 300 mother–child dyads in each of the CS and VD group. Data were collected through face-to-face interviews by using a standard questionnaire, which was first developed in the English language and later translate to Bengali (the native language of Bangladesh). Eight Bachelor of Science (B.Sc.) students collected data under the supervision of the principal investigator, the first author of this paper, who also trained properly all data collectors before starting data collection.

Exposure variable

The main exposure variable was the mode of delivery (CS vs. VD) that mothers used in their most recent live birth. Other exposure variables considered were maternal age of birth, place of residence, wealth quintile, education status of the mothers and their partners, number of children ever born, and mothers’ body mass index. These variables are found as important determinants of CS in national-level studies of Bangladesh [7, 24] as well as other LMICs.

Outcome variables

We considered a range of maternal and child health outcomes as outcome variables. Mothers’ health outcomes were headache (pain in the head or neck), after delivery hip pain (pain in the buttock or lower back), problem of daily activities (problems associated with daily work including cooking and walking), suffering physical problems (problems in any organ of the body including eye problem, backbone problem), and breastfeeding problem (women reported they were faced problem during breastfeeding). The type of physical health problems that women faced was also explored and the relevant variable was classified as no problem, eye problem, backbone problem. Breathing problem (problem during breath), frequent illness (measured by at least once quarterly), behavioural characteristics (classified as obstinate, restless, and quiet), food demand (5–6 times in a day for children under 2 years old and 4–5 times a day for the children above 2 years is considered as normal), sleeping hours (40% times a day is considered normal) were considered as child health outcomes. The relevant data were collected by asking the mothers about their health problems after the most recent delivery to the survey date. Child data were also collected from them by asking a separate set of questions. Precautious measures were taken to reduce the recall bias. As part of this, all respondents were asked to show the relevant health cards where available. If the health care cards were not available, respondents were asked several follow up questions to ensure respondents reported correct answers, as such, to reduce the recall bias.

Statistical analysis

We used mean and standard deviation to describe participants’ characteristics. The Pearson’s Chi-squared (χ2) test was used to find the significance of the difference of maternal and child health outcomes across methods of delivery (CS vs. VD). Association between outcome variables with methods of delivery was determined after adjusting for socio-demographic characteristics of the mothers. Multivariate logistic regression was used for this purpose if the outcome variable were dichotomous (yes, no). Multiple logistic regression model was used if the outcome variables had more than two categories. All results are reported as Odds Ratio (OR) and its 95% confidence interval (95% CI). All analyses were performed using the Statistical Package for Social Science (SPSS) version 20.0.

Ethical consideration

The Institutional Animal, Medical Ethics, Biosafety and Biosecurity Committee (IAMEBBC) of the Institute of Biological Science, University of Rajshahi, Bangladesh, reviewed and approved this study (approval number is 78/318/IAMEBBC/IBSc). Informed verbal consent was obtained from the study participants after exploring the objectives of this study. The confidentiality of the participants was ensured as well.

Results

The mean age of the mothers was 25.1 years and the mean weight was 53.14 kg (Table 1). A majority of the respondents had primary education (mean year of education was 5.40 years) and they had at least two children (mean number of children ever born was 1.9) at the time of the survey conducted. The mean age of marriage was around 16 years.

Table 1 Background characteristics of the respondents

The self-reported health problems among the mothers and their children across modes of delivery (CS vs. VD) are presented in Tables 2 and 3, respectively. Adverse mothers and child health outcomes were found higher among the mothers who performed CS and children born by CS. These differences were to be statistically significant at less than 5% level.

Table 2 Mothers’ physical health problems by mode of delivery
Table 3 Child health problems by mode of delivery

We run a series of multivariate logistic regression models to examine the effects of CS on different maternal and child health outcomes (Table 4). We found mothers who had CS than VD reported a 3.57 (95% CI, 2.34–4.62) times higher likelihood of headache and 3.26 times (95% CI, 2.80–4.24) higher likelihood of hip pain. Mothers who had CS operations in their most recent pregnancies were 2.68 times (95% CI, 1.90–3.87) more likely to report the problem in daily activities than their counterparts who had VD. The likelihood for backbone pain (OR, 3.58, 95% CI, 2.12–4.70) was found higher among mothers having CS than VD. Moreover, mothers who had CS were more likely to report the problem in breastfeeding (OR, 3.19, 95% CI, 2.90–4.20) than mothers who had VD.

Table 4 Odds ratio of mothers’ and children’s health problems among mothers who have performed caesarean delivery either vaginal delivery

The children of the mothers who had CS were reported 2.62 times (95% CI, 1.90–3.67) higher odds of breathing problem after delivery than the children of the mothers who had VD. Around 5 times (OR, 5.10; 95% CI, 3.90–6.20) higher likelihood of frequent illness was also found among children born by CS than VD. In addition, children of mothers who had CS than VD were reported a higher odd of quite behaviour (OR, 1.93, 95% CI, 1.01–2.89). The likelihoods of normal food demand and normal sleeping hour were found to be 55% (OR, 0.45, 95% CI, 0.12–0.98) and 31% (OR, 0.69, 95% CI, 0.20–1.00) lower, respectively, among children whose mothers had CS than the children whose mothers had VD.

Discussion

Through this study, we determined the effects of CS on the health and behavioural problems of mothers and their children. We reported a higher likelihood of health and behavioural problems among mothers who had CS and children who were born through CS. As far we know this observation is first in Bangladesh, as well as in other LMICs. Policies and programs from the governmental level to prevent medical unnecessary CS are important.

The use of CS was found associated with improvement in maternal and child health outcomes up to 1985, when the rates of CS were around 10–15% [25]. However, when the rates were crossed to 15% in the earlier part of 1990, it becomes a concern, since, such increasing rates of CS were showed no evidence of further improvements in maternal and child health [25, 26]. Even such increasing rates of CS, which are mostly performed without medical necessity, are found associated with obstetric complications and associated maternal and neonatal morbidities and mortalities [27]. A 14 years follow-up study in Canada of more than 2 million women found a 3 times higher risk of mortality from obstetric complications, including blood clots and heart attacks among the mother performed CS unnecessary [28]. Similarly, a higher likelihood of respiratory distress, metabolic and immune diseases are found among children born by CS than VD [28, 29]. There is also evidence that many of these adverse outcomes take a long time to recover and sometimes it stays lifelong [4, 19, 20, 29].

We found higher adverse health and behaviour problems are more common among the mothers who had CS as well as among their children. More than 83% of the mothers who had CS reported headaches and hip pain. These adverse outcomes are associated with anaesthesia. During CS, the doctor inserts a needle in the mother spinal area for administrating the pain medication. However, insertion punctures cover the spinal cord which leads to spinal fluids seepage and causes post-surgery headache [30,31,32]. Mothers suffering from this problem are mostly recovered within a week after delivery [31]. However, in some cases, the problem can stay longer period and could influence women daily activities and other associated physical health problems. This study also reported their higher likelihoods among the mothers who had CS than VD, which was similar to the findings of a study conducted in Australia [33]. Using post-partum care following the CS is important to overcome these complications. However, this is a further challenge in Bangladesh and other LMICs as post-partum care use is very low and many women consider these adverse outcomes are only for short time with no effective remedy [34].

We found CS mothers are more likely to face problems in exclusive breastfeeding—a similar finding reported in other LMICs [35,36,37,38]. The reason is lower earlier skin contact of mothers and children soon after delivery [39]. Mothers earlier return to the formal work, which is common among CS mothers as they are usually educated and belong to higher socioeconomic status, should be another predictor of lower exclusive breastfeeding following the CS [35, 39]. Importantly, lower exclusive breastfeeding is responsible for several adverse health outcomes of children, including frequent illness, lower food demand, and higher nutritional disorders that we also found in this study as similar to a previous study [35]. Researchers of a recent nationally representative study in Bangladesh concluded lowering exclusive breastfeeding is associated with increased infectious diseases among children, including diarrhoea and acute respiratory infection [40]. In addition, in this study, breathing problems, quite behavioural characteristics, and lower sleeping hours were found following the CS than VD. These adverse outcomes should be considered as consequences of lower exclusive breastfeeding that we found in this study.

This study has several strengths and some limitations. To our knowledge, this is the first study of its kind that considered CS and a range of adverse health and behavioural outcomes of mothers and their children. The associations were adjusted with the range of confounders’ factors which make this study findings more precise and should be used for policymaking in Bangladesh as well as in other LMICs. However, our relationship is correlational only rather than causal. Moreover, the data for this study were collected for some selected communities; therefore, the associations reported should not be representative to all areas of Bangladesh.  In addition, data were collected by asking respondents a series of relevant questions. Relevant health care cards were also checked. However, instead of these pre-cautious measures, recall bias is still a major issue for this study. However, any such errors is likely to be random.

Conclusion

The use of CS increases the risk of several adverse health and behavioural outcomes of the mothers and their children. The risks of headache, after delivery hip pain, the problem of daily activities, suffering physical problems, and breastfeeding problem were found higher among mothers who had CS in their most recent pregnancies than mothers who had VD. In addition, children born by the CS reported a higher risk of breathing problems, frequent illness, and quite behavioural characteristics. Lower risk of normal food demand and lower sleeping hours were also found among children born by CS than children born by VD. Policies and programs to prevent unnecessary CS and ensure frequent health check-ups of the mothers and their children following the CS operation are important.

Availability of data and materials

The ethical review broad impose restriction to share this data publicly. However, data can be made available upon reasonable request to the corresponding author and approval from the ethical review broad.

Abbreviations

CS:

Caesarean section

VD:

Vaginal delivery

WHO:

World Health Organization

LMICs:

Low- and middle-income countries

References

  1. Moore B. Appropriate technology for birth. Lancet. 1985;326(8458):787.

    Article  Google Scholar 

  2. Dumont A, De Bernis L, Bouvier-olle M-H, Bréart G, Group MS. Caesarean section rate for maternal indication in sub-Saharan Africa: a systematic review. Lancet. 2001;358(9290):1328–33.

  3. Betrán AP, Ye J, Moller A-B, Zhang J, Gülmezoglu AM, Torloni MR. The increasing trend in caesarean section rates: global, regional and national estimates: 1990–2014. PLoS One. 2016;11(2): e0148343.

    Article  Google Scholar 

  4. Lumbiganon P, Laopaiboon M, Gülmezoglu AM, Souza JP, Taneepanichskul S, Ruyan P, et al. Method of delivery and pregnancy outcomes in Asia: the WHO global survey on maternal and perinatal health 2007–08. The Lancet. 2010;375(9713):490–9.

    Article  Google Scholar 

  5. Linton A, Peterson MR, Williams TV. Effects of maternal characteristics on cesarean delivery rates among US department of defense healthcare beneficiaries, 1996–2002. Birth. 2004;31(1):3–11.

    Article  Google Scholar 

  6. Mi J, Liu F. Rate of caesarean section is alarming in China. The Lancet. 2014;383(9927):1463–4.

    Article  Google Scholar 

  7. Khan MN, Islam MM, Shariff AA, Alam MM, Rahman MM. Socio-demographic predictors and average annual rates of caesarean section in Bangladesh between 2004 and 2014. PLoS One. 2017;12(5): e0177579.

    Article  Google Scholar 

  8. Lin H-C, Xirasagar S. Institutional factors in cesarean delivery rates: policy and research implications. Obstet Gynecol. 2004;103(1):128–36.

    Article  Google Scholar 

  9. Barber EL, Lundsberg L, Belanger K, Pettker CM, Funai EF, Illuzzi JL. Contributing indications to the rising cesarean delivery rate. Obstet Gynecol. 2011;118(1):29.

    Article  Google Scholar 

  10. Johnson C, Choubey V, Satin A, Werner E. Malpractice and obstetric practice: the correlation of malpractice premiums to rates of vaginal and cesarean delivery. Obstet Anesth Dig. 2017;37(1):11–2.

    Article  Google Scholar 

  11. Campbell OM, Graham WJ, Group LMSSs. Strategies for reducing maternal mortality: getting on with what works. Lancet. 2006;368(9543):1284–99.

  12. Keag OE, Norman JE, Stock SJ. Long-term risks and benefits associated with cesarean delivery for mother, baby, and subsequent pregnancies: systematic review and meta-analysis. PLoS Med. 2018;15(1): e1002494.

    Article  Google Scholar 

  13. Excellence NIfHaC. Caesarean Section (NICE Clinical Guideline 132). Available at: https://www.nice.org.uk/guidance/CG132 [Accessed 22 March 2018]: 2011.

  14. Grivell RM, Dodd JM. Short-and long-term outcomes after cesarean section. Expert Rev Obstet Gynecol. 2011;6(2):205–15.

    Article  Google Scholar 

  15. Smith GC, Wood AM, Pell JP, Dobbie R. First cesarean birth and subsequent fertility. Fertil Steril. 2006;85(1):90–5.

    Article  Google Scholar 

  16. Mollison J, Porter M, Campbell D, Bhattacharya S. Primary mode of delivery and subsequent pregnancy. BJOG Int J Obstet Gynaecol. 2005;112(8):1061–5.

    Article  CAS  Google Scholar 

  17. Bowman ZS, Smith KR, Silver RM. Cesarean delivery and risk for subsequent ectopic pregnancy. Am J Perinatol. 2015;32(09):815–20.

    Article  Google Scholar 

  18. Jackson S, Fleege L, Fridman M, Gregory K, Zelop C, Olsen J. Morbidity following primary cesarean delivery in the Danish National Birth Cohort. Am J Obstet Gynecol. 2012;206(2):139.

    Article  Google Scholar 

  19. Gray R, Quigley M, Hockley C, Kurinczuk J, Goldacre M, Brocklehurst P. Caesarean delivery and risk of stillbirth in subsequent pregnancy: a retrospective cohort study in an English population. BJOG Int J Obstet Gynaecol. 2007;114(3):264–70.

    Article  CAS  Google Scholar 

  20. Kennare R, Tucker G, Heard A, Chan A. Risks of adverse outcomes in the next birth after a first cesarean delivery. Obstet Gynecol. 2007;109(2):270–6.

    Article  Google Scholar 

  21. Yang Q, Wen S, Oppenheimer L, Chen X, Black D, Gao J, et al. Association of caesarean delivery for first birth with placenta praevia and placental abruption in second pregnancy. BJOG Int J Obstet Gynaecol. 2007;114(5):609–13.

    Article  CAS  Google Scholar 

  22. Taylor LK, Simpson JM, Roberts CL, Olive EC, Henderson-Smart DJ. Risk of complications in a second pregnancy following caesarean section in the first pregnancy: a population-based study. Med J Aust. 2005;183(10):515–9.

    Article  Google Scholar 

  23. Kadam P, Bhalerao S. Sample size calculation. Int J Ayurveda Res. 2010;1(1):55.

    Article  Google Scholar 

  24. Khan MN, Rahman MM, Shariff AA, Rahman MM, Rahman MS, Rahman MA. Maternal undernutrition and excessive body weight and risk of birth and health outcomes. Arch Public Health. 2017;75(1):12.

    Article  Google Scholar 

  25. Temmerman M. Caesarean section surgical techniques: all equally safe. Lancet. 2016;388(10039):8–9.

    Article  Google Scholar 

  26. Roberts CL, Nippita TA. International caesarean section rates: the rising tide. Lancet Glob Health. 2015;3(5):e241–2.

    Article  Google Scholar 

  27. Rezaee-Zavareh MS, Salamati P, Alavian SM. Caesarean section in Iran. Lancet. 2016;387:28–9.

    Article  Google Scholar 

  28. Liu S, Liston RM, Joseph K, Heaman M, Sauve R, Kramer MS. Maternal mortality and severe morbidity associated with low-risk planned cesarean delivery versus planned vaginal delivery at term. Can Med Assoc J. 2007;176(4):455–60.

    Article  Google Scholar 

  29. Lagercrantz H. The good stress of being born. Acta Paediatr. 2016;105(12):1413–6.

    Article  Google Scholar 

  30. Hwang J, Ho S, Wang J, Liu H. Post dural puncture headache in cesarean section: comparison of 25-gauge Whitacre with 25-and 26-gauge Quincke needles. Acta Anaesthesio Logica Sinica. 1997;35(1):33–7.

    CAS  Google Scholar 

  31. Laviola S, Kirvela M, Spoto M-R, Tschuor S, Alon E. Pneumocephalus with intense headache and unilateral pupillary dilatation after accidental dural puncture during epidural anesthesia for cesarean section. Anesth Analg. 1999;88(3):582–3.

    CAS  PubMed  Google Scholar 

  32. Niklasson B, Georgsson Öhman S, Segerdahl M, Blanck A. Risk factors for persistent pain and its influence on maternal wellbeing after cesarean section. Acta Obstet Gynecol Scand. 2015;94(6):622–8.

    Article  Google Scholar 

  33. Kealy MA, Small RE, Liamputtong P. Recovery after caesarean birth: a qualitative study of women’s accounts in Victoria, Australia. BMC Pregnancy Childbirth. 2010;10(1):47.

    Article  Google Scholar 

  34. Khan R, Blum LS, Sultana M, Bilkis S, Koblinsky M. An examination of women experiencing obstetric complications requiring emergency care: perceptions and sociocultural consequences of caesarean sections in Bangladesh. J Health Popul Nutr. 2012;30(2):159.

    Article  Google Scholar 

  35. Hobbs AJ, Mannion CA, McDonald SW, Brockway M, Tough SC. The impact of caesarean section on breastfeeding initiation, duration and difficulties in the first four months postpartum. BMC Pregnancy Childbirth. 2016;16(1):90.

    Article  Google Scholar 

  36. Regan J, Thompson A, DeFranco E. The influence of mode of delivery on breastfeeding initiation in women with a prior cesarean delivery: a population-based study. Breastfeed Med. 2013;8(2):181–6.

    Article  Google Scholar 

  37. Ahmadi M, Moosavi SM, Mousavi SJ, Ghasemi Y. Cessation of exclusive breastfeeding in cesarean section mothers: need more attention. Am J Med Med Sci. 2015;5(2):82–6.

    Google Scholar 

  38. Liu X, Zhang J, Liu Y, Li Y, Li Z. The association between cesarean delivery on maternal request and method of newborn feeding in China. PLoS One. 2012;7(5): e37336.

    Article  CAS  Google Scholar 

  39. Zanardo V, Pigozzo A, Wainer G, Marchesoni D, Gasparoni A, Di Fabio S, et al. Early lactation failure and formula adoption after elective caesarean delivery: cohort study. Arch Dis Childhood-Fetal Neonatal. 2013. https://doi.org/10.1136/archdischild-2011-301218.

    Article  Google Scholar 

  40. Khan MN, Islam MM. Effect of exclusive breastfeeding on selected adverse health and nutritional outcomes: a nationally representative study. BMC Public Health. 2017;17(1):889.

    Article  Google Scholar 

Download references

Acknowledgements

We acknowledge the support of the Department of Population Sciences and Human Resource Development, University of Rajshahi, Bangladesh, where this study was conducted. We also acknowledge all mothers who were participated in this study.

Funding

This study is conducted without any financial support from any sources.

Author information

Authors and Affiliations

Authors

Contributions

Rahman M designed the study, performed data analysis, and write the result section. Khan N writes the introduction and the discussion section and revised all versions of the manuscript. Khan A, Alam M and Rahman A critically revised the paper. All authors approved the final version of this manuscript.

Corresponding author

Correspondence to Mostafizur Rahman.

Ethics declarations

Ethics approval and consent to participate

The Institutional Animal, Medical Ethics, Biosafety and Biosecurity Committee (IAMEBBC) of the Institute of Biological Science, University of Rajshahi, Bangladesh, reviewed and approved this study (approval number is 78/318/IAMEBBC/IBSc). Informed verbal consent was obtained from the study participants after exploring the objectives of this study. Confidentiality of the participants was ensured as well.

Consent for publication

Not applicable.

Competing interest

None.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Rahman, M., Khan, N., Rahman, A. et al. Long-term effects of caesarean delivery on health and behavioural outcomes of the mother and child in Bangladesh. J Health Popul Nutr 41, 45 (2022). https://doi.org/10.1186/s41043-022-00326-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1186/s41043-022-00326-6

Keywords

  • Caesarean delivery
  • Adverse health effects
  • Multivariate logistic regression model
  • Bangladesh