PREDICTORS OF EMERGENCY SECOND CAESAREAN SECTION AMONG WOMEN WITH ONE PREVIOUS SCAR DELIVERING AT IRINGA REGIONAL REFERRAL HOSPITAL: HOSPITAL BASED CROSS-SECTIONAL STUDY: HOSPITAL BASED CROSS-SECTIONAL STUDY

BACKGROUND: A significant increase in second emergency caesarean sections (CS) is associated with numerous adverse obstetric outcomes. Women have the opportunity to undergo planned childbirth, potentially preventing the need for a second emergency caesarean section. Objective: To determine the predictors of emergency second caesarean section among pregnant women delivering at Iringa Referral Hospital. METHODOLOGY: The study was conducted at Iringa Hospital over six months using a cross-sectional design. Participants were recruited serially, involving women with one previous scar arriving for delivery. Data were collected using a structured questionnaire, and analysis was conducted using SPSS. Chi-square tests were used to test the association of variables, and binary logistic regression assessed significance at a 95% confidence interval (CI) with a p-value <0.05. RESULTS: The study recruited a total of 355 participants who had second caesarean deliveries, with 204 (57.46%) having an emergency caesarean and 151 (42.54%) having an elective caesarean. The significant predictors of emergency second CS were lack of employment [AOR=3.02, 95% CI (1.59, 15.46)], late booking (11–20 weeks) [AOR=4.70, 95% CI (1.18, 18.64)] and >21 weeks [AOR=6.53, 95% CI (1.02, 41.67)], category of healthcare provider [AOR=3.87, 95% CI (1.30, 11.53)], lack of information on the mode of delivery during ANC [AOR=3.02, 95% CI (2.59, 15.46)], third-trimester ultrasound scanning [AOR=10.05, 95% CI (3.95, 25.61)], and pregnancy interval [AOR=10.05, 95% CI (3.95, 25.61)]. CONCLUSION: Emergency second caesarean sections (CS) are prevalent. Most women originate from primary healthcare centers, where nurses primarily manage them during ANC without establishing a birth plan. The number of antenatal visits and delays in booking exacerbate the situation. Therefore, all women with previous scars who arrive late for booking must receive attention from a physician. They should undergo critical evaluation and counseling on their birth plan.