{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T23:40:05Z","timestamp":1790293205242,"version":"4.1.0"},"reference-count":53,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2025,2,12]],"date-time":"2025-02-12T00:00:00Z","timestamp":1739318400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec022\">\n<jats:title>Background<\/jats:title>\n<jats:p>Even if the ideal rate for caesarean section (CS) is considered 10\u201315%, worldwide CS rates have been steadily increasing, without significant additional benefit to women\u2019s health. Its overuse was associated with maternal and fetal complications. Therefore, this study aimed to determine the rate of CS delivery and associated factors among women delivered in health facilities in Ghana.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec023\">\n<jats:title>Methods<\/jats:title>\n<jats:p>A cross-sectional study was conducted using the 2022 DHS datasets from Ghana. A total of 5231 weighted samples were included. STATA.16 was used for analysis. A multilevel logistic regression was applied. An adjusted odds ratio with a 95% CI and a p-value &lt;\u2009 0.05 was used to declare significantly associated factors.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec024\">\n<jats:title>Result<\/jats:title>\n<jats:p>The prevalence of CS in Ghana was 20.29% [95% CI = 19.23\u201321.41%]. Age 25-34 [AOR = 1.32, CI: 1.04, 1.68] and 35 + [AOR = 1.57, CI: 1.16, 2.11], primary [AOR = 1.58, CI: 1.21, 2.07], secondary [AOR = 1.36, CI: 1.07, 1.73], and higher [AOR = 2.24, CI: 1.58, 3.17] education, richer [AOR = 1.45, CI: 1.06, 1.99] and richest [AOR = 2.35, CI: 1.63, 3.39] wealth index, employment [AOR = 0.77, CI: 0.64, 0.92], primiparous [AOR = 1.33, CI: 1.07, 1.67], giving first birth after the age of 35 [AOR = 4.58, CI: 1.88, 11.19], multiple pregnancy [AOR = 5.53, CI: 4.02, 7.62], large birth size [AOR = 1.25, CI: 1.06, 1.48], 4\u20136\u2009kg birth weight [AOR = 2.13, CI: 1.55, 2.92], as well as residing in Volta [AOR = 1.98, 95% CI: 1.22, 3.22] and Bono East [AOR = 2.02, 95% CI: 1.28, 3.19] regions were significant factors associated with CS delivery in Ghana.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec025\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>The rate of CS was higher than previous studies in Ghana and the WHO recommended level, making it a public health concern. Age, education, wealth, employment, parity, age at first birth, pregnancy type, birth size, birth weight, and region were significantly associated with CS. Therefore, strategies aimed at examining guidelines for proper indications and uses of CS may lead to an improvement CS rate.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0318223","type":"journal-article","created":{"date-parts":[[2025,2,12]],"date-time":"2025-02-12T18:43:38Z","timestamp":1739385818000},"page":"e0318223","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":10,"title":["Caesarean section delivery and its associated factors in Ghana: A multilevel analysis"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8206-4195","authenticated-orcid":true,"given":"Werkneh Melkie","family":"Tilahun","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mulat Belay","family":"Simegn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-7896-9087","authenticated-orcid":true,"given":"Alegntaw","family":"Abate","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eyasu Bamlaku","family":"Golla","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed Ahmed","family":"Ali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hawi","family":"Kumbi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Smegnew Gichew","family":"Wondie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9027-9847","authenticated-orcid":true,"given":"Habtamu","family":"Geremew","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,2,12]]},"reference":[{"key":"pone.0318223.ref001","author":"World Health Organization","year":"2024 March 7, 2024"},{"issue":"5","key":"pone.0318223.ref002","doi-asserted-by":"crossref","first-page":"e1274","DOI":"10.1002\/hsr2.1274","article-title":"Global increased cesarean section rates and public health implications: a call to action","volume":"6","author":"CM Angolile","year":"2023","journal-title":"Health Sci Rep"},{"issue":"4","key":"pone.0318223.ref003","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1080\/01443610802091545","article-title":"Caesarean section on request: are there loco-regional factors influencing maternal choice? 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