The Relationship between Socioeconomic Status and the Prevalence of Elective Cesarean Section in Nulliparous Women in Niknafs Teaching Center, Rafsanjan, Iran

In the last decades, the increased rate of cesarean section has challenged its primary goals seriously. Many researchers showed the positive relationship between socioeconomic status and prevalence of cesarean delivery. However, it seems that the prevalence of elective cesarean is increasing in low socioeconomic classes, too. The aim of this study was to evaluate the relationship between socioeconomic status and the prevalence of elective cesarean in nulliparous women in Niknafs Teaching Centre, Rafsanjan, Iran. This cross-sectional study was carried out in Niknafs Teaching Center, Rafsanjan, Iran during 8 months. A total number of 459 nulliparous women registered in the study. A valid questionnaire was completed during a short time interview with the subjects. It included the demographic, economic, and educational status of the subjects as well as information about the delivery type. The collected data was analyzed using chi-square and Fisher's exact tests in SPSS16. Five socioeconomic groups were defined as very poor, poor, fair, good, and very good. Overall, 74% of the subjects were placed in fair and lower groups. Significant relations were observed between socioeconomic status and primary elective cesarean delivery (P < 0.001) and also the final rate of cesarean delivery (P = 0.02). However, there was no statistically significant relationship between the reason of cesarean delivery and socioeconomic classes of the mothers. The improvement of socioeconomic status of the subjects showed a linear relationship with increased demand for elective cesarean delivery. However, this type of cesarean was also commoner than standard rates in low socioeconomic classes. This rate could impose lots of financial pressure to the health system and could be considered as a cause of inefficiency in the health care delivery system.