Caesarean deliveries and their impact on financial burden and quality of life among post-partum mothers in Tamil Nadu, India.

INTRODUCTION: Caesarean section (C-section) deliveries are on the rise globally, often with significant health and economic consequences. This study investigates the prevalence and factors associated with C-section deliveries, and their association with out-of-pocket expenditures (OOPE) and health-related quality of life (HRQL) among post-partum mothers in Tamil Nadu, India. METHODS: A cross sectional study among 475 randomly selected post-partum mothers was conducted during April-June 2023. Data on demographic and obstetric characteristics and OOPE were collected using a structured survey questionnaire. HRQL was assessed using the 12-Item Short Form Survey (SF-12). Binary logistic regression analysis was used to compute Adjusted Odds Ratios (AOR) to identify the factors associated with C-section deliveries, and identify the association between C-section deliveries with OOPE and HRQL. RESULTS: C-section deliveries accounted for 52.60% of all births. High-risk pregnancies (AOR = 17.21, 95% CI = 7.57-39.13, p < 0.001), and private healthcare facilities (AOR = 3.02, 95% CI = 1.62-5.65, p = 0.001) were associated with C-sections. C-section delivery was significantly associated with higher OOPE (AOR = 2.05, 95% CI = 1.22-3.47, p = 0.007) and poor physical HRQL (AOR = 0.31, 95%CI = 0.18-0.55, p < 0.001). CONCLUSIONS: One in two deliveries in Tamil Nadu are C-section deliveries and were associated with higher financial burden and poorer quality of life among post-partum mothers. Strategies targeted at reducing unwarranted C-sections are needed.