{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T18:07:05Z","timestamp":1790100425454,"version":"4.0.1"},"reference-count":44,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T00:00:00Z","timestamp":1790035200000},"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=\"sec001\">\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>C-section deliveries accounted for 52.60% of all births. High-risk pregnancies (AOR\u2009=\u200917.21, 95% CI\u2009=\u20097.57\u201339.13, p\u2009&lt;\u20090.001), and private healthcare facilities (AOR\u2009=\u20093.02, 95% CI\u2009=\u20091.62\u20135.65, p\u2009=\u20090.001) were associated with C-sections. C-section delivery was significantly associated with higher OOPE (AOR\u2009=\u20092.05, 95% CI\u2009=\u20091.22\u20133.47, p\u2009=\u20090.007) and poor physical HRQL (AOR\u2009=\u20090.31, 95%CI\u2009=\u20090.18\u20130.55, p\u2009&lt;\u20090.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0358778","type":"journal-article","created":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T17:29:51Z","timestamp":1790098191000},"page":"e0358778","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Caesarean deliveries and their impact on financial burden and quality of life among post-partum mothers in Tamil Nadu, India"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-5610-7886","authenticated-orcid":true,"given":"Retna Sheeja","family":"Pushpa Raj","sequence":"first","affiliation":[{"name":"Central University of Kerala","place":["Kasaragod, Kerala, India"],"department":["Department of Public Health Sciences"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9358-9712","authenticated-orcid":true,"given":"Prakash Babu","family":"Kodali","sequence":"additional","affiliation":[{"name":"Central University of Kerala","place":["Kasaragod, Kerala, India"],"department":["Department of Public Health Sciences"]},{"name":"University of California","place":["San Francisco, California, United States of America"],"department":["Center for Tobacco Control Research and Education"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,9,22]]},"reference":[{"key":"pone.0358778.ref001","unstructured":"MOHFW. 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