{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T13:42:33Z","timestamp":1761745353907},"reference-count":25,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2020,12,31]],"date-time":"2020-12-31T00:00:00Z","timestamp":1609372800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To investigate the factors associated with cesarean section (CS) in Bhutan.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a cross\u2010sectional study, using the retrospective data from the birth registers maintained in comprehensive emergency obstetric care centers for the year 2018. The data were entered in <jats:sc>excel<\/jats:sc> 2013 and analyzed using STATA 13. Multiple logistic regression was used to understand the factors associated with CS in Bhutan.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The rate of CS in Bhutan was 18.7%. The indications for CS were previous CS, fetal distress, prolonged labor, and failed induction. The factors associated with CS were maternal age over 25\u00a0years, male child, women with smaller number of living children, multiple pregnancy, and gestation over 40\u00a0weeks. In addition, mothers delivering in Samtse Hospital and Central Regional Referral Hospital had higher odds of CS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In Bhutan, CS was commonly performed for mothers with previous CS, fetal distress, and prolonged labor. Increasing maternal age, multiple pregnancy, and postdated pregnancy and those with one child, or none, were more likely to undergo CS. To reduce the CS rate, Bhutan should focus on decreasing the primary CS rate as well as preventing over\u2010diagnosis of prolonged labor by focusing on the partograph.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ijgo.13506","type":"journal-article","created":{"date-parts":[[2020,12,1]],"date-time":"2020-12-01T23:42:26Z","timestamp":1606866146000},"page":"520-526","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Indications and factors associated with cesarean section in Bhutan: A hospital\u2010based study"],"prefix":"10.1002","volume":"153","author":[{"given":"Thinley","family":"Dorji","sequence":"first","affiliation":[{"name":"Kanglung Hospital Trashigang Bhutan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karma","family":"Wangmo","sequence":"additional","affiliation":[{"name":"Regional Livestock Development Center Khangma Bhutan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yeshey","family":"Dorjey","sequence":"additional","affiliation":[{"name":"Phuntsholing Hospital Phuntsholing Bhutan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Namkha","family":"Dorji","sequence":"additional","affiliation":[{"name":"Central Regional Referral Hospital Gelephu Bhutan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deep","family":"Kiran Chhetri","sequence":"additional","affiliation":[{"name":"Trashigang Hospital Trashigang Bhutan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sangay","family":"Tshering","sequence":"additional","affiliation":[{"name":"Jigme Dorji Wangchuck National Referral Hospital Thimphu Bhutan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Passang","family":"Wangmo","sequence":"additional","affiliation":[{"name":"Faculty of Nursing and Public Heath Thimphu Bhutan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tshokey","family":"Tshokey","sequence":"additional","affiliation":[{"name":"Jigme Dorji Wangchuck National Referral Hospital Thimphu Bhutan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,12,31]]},"reference":[{"key":"e_1_2_8_2_1","series-title":"2.5 Indicator 5: Caesarean sections as a proportion of all births","volume-title":"Monitoring Emergency Obstetric Care: A Handbook","author":"World Health Organization","year":"2009"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.13592"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1258\/om.2008.080019"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)60828-5"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2393-9-17"},{"issue":"29","key":"e_1_2_8_7_1","first-page":"489","article-title":"Indications for and risks of elective cesarean section","volume":"112","author":"Mylonas I","year":"2015","journal-title":"Deutsches \u00c4rzteblatt Int"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)31930-5"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu11112723"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.13526"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)61870-5"},{"key":"e_1_2_8_12_1","unstructured":"Ministry of Health.Annual Health Bulletin 2019. 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