Research | Open Access | Volume 9 (3): Article 118 | Published: 20 Jul 2026
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Jonhas Masatu1,2,&, Ismail Habib3, Rogath Kishimba1,2, Rose Mpembeni1
1Department of Epidemiology and Biostatistics (SPHSS), School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania, 2Reproductive and Child Health Directorate (RCH), Ministry of Health (MoH), Dodoma, Tanzania, 3Ministry of Health (MoH), Dodoma, Tanzania
&Corresponding author: Jonhas Masatu, Department of Epidemiology and Biostatistics (SPHSS), School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania, E-mail: masatu.jm@gmail.com, ORCID: https://orcid.org/0009-0001-7465-343X
Received: 14 Dec 2024, Accepted: 16 Jul 2026, Published: 20 Jul 2026
Domain: Maternal and Child Health
Keywords: Caesarean section, indications, outcomes
©Jonhas Masatu et al. Journal of Interventional Epidemiology and Public Health (ISSN: 2664-2824). This is an Open Access article distributed under the terms of the Creative Commons Attribution International 4.0 License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Cite this article: Jonhas Masatu et al., Facility-based assessment of caesarean section indications and outcomes in Njombe Region, Tanzania, 2024. Journal of Interventional Epidemiology and Public Health. 2026; 9(3):118. https://doi.org/10.37432/jieph-d-24-02038
Introduction: Caesarean section (CS) is a critical intervention for managing maternal and neonatal complications when vaginal delivery fails. While global CS rates rose from 7% in the year 1990 to 21% in the year 2021, during which excessive reliance on CS without clear medical indications was recorded, this has raised concerns, especially in developing countries like Tanzania, where the CS rate has increased from 7% in the year 1990 up to 13% in the year 2021. This study examines the indications and outcomes of CS among women who delivered in health facilities in the Njombe region, Tanzania.
Methods: A facility-based cross-sectional study was conducted from March to May 2024, involving 567 post-delivery women (PDW) selected through multistage cluster sampling. Data were collected using structured questionnaires and hospital records, focusing on demographic, clinical, and delivery details. Descriptive statistics analysis was used to analyse categorical and continuous variables.
Results: The study revealed that 60.1% of CS were elective, whereby a previous caesarean scar was the most common indication (19.3%). Neonatal complications were more prevalent after CS (32.6%) compared to vaginal deliveries (14.9%), with early neonatal sepsis being the leading complication in both modes of delivery. Maternal complications after CS included postpartum haemorrhage (39.4%) and infections (30.3%), compared to a lower complication rate in vaginal deliveries (3.6%).
Conclusions: Elective CS remains high, posing unnecessary risks and resource burdens. Neonatal outcomes, particularly early neonatal sepsis, highlight gaps in infection prevention and neonatal care. Maternal complications such as postpartum haemorrhage underscore the need for enhanced obstetric management during the labour and delivery period. Strengthening antenatal care to improve birth preparedness, adhering to clinical guidelines for CS, and investing in neonatal and maternal care during the labour and delivery period will help reduce unnecessary CS and improve maternal and neonatal outcomes.
Caesarean section (CS) is an important obstetric surgery that has helped to dramatically reduce maternal and newborn morbidity and mortality. Indications for CS include maternal issues such as obstructed labour, severe preeclampsia, and past uterine surgeries, as well as fetal indications like distress and malpresentation. These conditions pose life-threatening risks for both the mother and child, and CS often provides a safer delivery option in such cases.
Globally, the rate of CS delivery has been increasing, frequently exceeding the World Health Organisation-recommended rate of 10-15% in many regions, with significant differences between high- and low-income countries. In recent years, CS rates have escalated from 7% in the year 1990 to 21% in the year 2021, especially in low- and middle-income countries (LMICs), where accessibility to the procedure has increased as health care services have improved [1]. In Tanzania, the national CS rate has increased from 7% in the year 1990 to 13% in the year 2021, and the Njombe region represents the highest caesarean rate of 29% in the year 2021, which is higher compared to all regions in Tanzania. However, there are significant regional variations, suggesting disparities in access to and quality of obstetric care [2].
Despite its benefits, CS is associated with increased risks of maternal complications, such as postpartum haemorrhage and infections, as well as neonatal complications like respiratory distress syndrome. However, excessive reliance on caesarean delivery can lead to adverse maternal and neonatal outcomes, particularly when performed without clear clinical indications. Literature highlights a growing concern over non-medical factors influencing CS rates, such as patient preference and institutional policies, particularly in sub-Saharan Africa, where healthcare resources are limited [3,4]. The Outcomes of caesarean delivery vary significantly based on maternal and neonatal health, timing, and the quality of healthcare services. Studies have shown that in some contexts, CS is associated with an increased risk of postpartum haemorrhage, infections, and neonatal respiratory distress [6]. In low and middle-income countries (LMICs), including Tanzania, the challenge of indications and outcomes of caesarean delivery, especially in resource-constrained settings, where access to comprehensive obstetric care varies significantly between regions, is not well studied [6]. However, there is limited data specifically addressing the indications and outcomes of CS in Tanzania and Njombe region [2]. There is limited information on the indications and outcomes of caesarean section in the Njombe region [2]. This study aims to assess the indications and outcomes of caesarean sections among women who delivered in health facilities in the Njombe region, Tanzania. Given the increasing global concern over the rising CS rates and their potential implications, this study provides essential evidence to guide clinical practices, resource allocation, and maternal health strategies in Tanzania. By understanding the indications and outcomes of CS, we will provide evidence-based insights that may improve clinical practices and enhance maternal and neonatal outcomes in the Njombe region and Tanzania in general.
Study area
The study was carried out in the Njombe region of Tanzania. Njombe region is one of 26 regions found in Tanzania’s mainland, with a population of 889,946 people (males: 420,533 and females: 469,413). It’s bordered by the Iringa region in the north, the Mbeya region in the east, Ruvuma in the south, and Lake Nyasa in the western part. It has six district councils, which are Njombe District Council (DC), Njombe Town Council (TC), Ludewa DC, Makambako TC, Makete DC, and Wanging’ombe DC. It has a total of 337 health facilities, which include 271 dispensaries, 44 health centres, and 22 hospitals. There are 24 health facilities that provide caesarean delivery services, which include 11 hospitals and 13 health centres. District Health Information System data show that in 2023, the Njombe region reported 25,573 deliveries, of which 8,297 were CS.
Study design
We conducted a facility-based descriptive cross-sectional study using a quantitative approach to determine the indications and outcomes of caesarean sections among women who delivered in health facilities in the Njombe region from March to May 2024.
Study population
The study involved a sample of 567 Post Delivery Women (PDW) who gave birth in selected health facilities in the Njombe region from March to May 2024. We included postnatal women who gave birth in selected health facilities from March to May 2024 and who delivered in selected health facilities within 1 to 14 days, women who were able to respond to the questions, which means they were not critically ill patients, and those who formally consented to participate in this study. However, we excluded postnatal women who gave birth in the selected health facilities from March to May 2024 who were not documented in the postnatal register number 12 and had no RCH card number 4.
Sampling procedures
The three-stage cluster sampling technique was employed, whereby in the first stage, three district councils were selected using simple random sampling out of six in the Njombe region. In the second stage, all health facilities providing CS services within the selected three district councils were listed, and only six health facilities out of a total of 24 in the region were selected, with two health facilities chosen from each district council. In the third stage is the selection of Post-Delivery Women (PDW) was conducted from each sampled health facility. The required sample size was allocated from each health facility using probability proportional to size (PPS) based on the average number of deliveries delivered in each health facility during the study period. To obtain the sample size of each health facility, the sampling fraction was calculated by dividing the required sample size (n) by the total number of deliveries (N) recorded by all selected health facilities. The number of participants to be recruited from each health facility was then determined by multiplying this sampling fraction by the total number of deliveries in that health facility.
At each health facility, the data collector obtained delivery registers and identified all eligible PDW who met the inclusion criteria during the study period and enrolled in the study. Simple random sampling techniques using a random number generator generated by EPI Info 7 were applied during the selection of district councils, health facilities and eligible study participants until the required sample size of PDW was reached.
Simple random sampling using random numbers generated by Epi Info 7 was applied during the selection of district councils, health facilities, and eligible participants whenever more than the required number of women were available for recruitment.
Study variables
The dependent variables were Caesarean section, which was a binary variable (CS Yes or CS No), and the independent variables were social demographics, which included age, mother’s education, marital status, occupation and residence. Clinically related factors included parity, gravidity, gestation age at delivery, abortion history, number of children, height, and previous caesarean scar, caesarean section history; maternal height and danger signs during pregnancy, which were collected from ANC card number 4, total ANC visits, baby sex, number of babies and baby weight. The indications of CS variables were placental abruption, placenta previa, multiple pregnancy, prolonged labour, cephalopelvic disproportion, obstructed labour, big baby, transverse lie, severe eclampsia, cord prolapse, mal-presentation, fetal distress, previous caesarean scar and other indications. The outcomes of CS were classified as maternal and newborn outcomes, where the maternal outcomes were;
Maternal complications, which might be yes or no and the complications were: Postnatal psychosis, anaesthetic complications, severe anaemia, severe eclampsia, postnatal infections, post-partum haemorrhage, and other complications. Also, the newborn outcomes were classified as Apgar score within 5 minutes after delivery which was grouped as (1-3) very low, (4-6) low and (7-10) good. Other newborn outcomes were born alive or dead and newborn complications, grouped as yes or no, including birth asphyxia, respiratory distress, meconium aspiration syndrome, hypoglycemia, hypothermia, neurological complications, early neonatal jaundice, early neonatal sepsis and other newborn complications.
Data collection and management
Data were collected by six trained and experienced nurses-midwives (one from each health facility). They had two days of training prior to data collection. They were trained on the study objectives, ethical issues, sampling procedure, and data collection tool. Obstetric Surgeons or Gynaecologists from each health facility were involved in the data collection process, especially in reviewing the indications, outcomes of CS and other medical related matter basing on the study objectives
During data collection, PDW who were admitted to postnatal wards, delivered within fourteen days of the study, and met the inclusion criteria were interviewed. The study used the Kobo Collector toolbox with closed-ended questions for data collection. Important documents, like PDW files, partographs, labour and delivery registers, and ANC card number 4, were reviewed to obtain important obstetric information. In terms of data management, the principal investigator performed daily checks on the data to ensure its accuracy before uploading it to the final Excel sheet. Any variables with missing or incorrect information were identified and corrected by recalling the data collectors and reviewing the labour and delivery registers, ensuring data integrity throughout the data collection process. Once data collection was completed, the final dataset was downloaded from Kobo Toolbox via the data extraction dropdown menu.
Data analysis
To ensure data consistency and minimise entry errors, the data were precisely cleaned using Microsoft Excel version 12 before analysis. The filter and sort functions were employed to logically organise the dataset, which facilitated the identification of outliers and incorrect entries. These discrepancies were corrected, with outlier variables being verified and amended by cross-referencing the participants’ information from the labour and delivery register using their unique identification numbers. Descriptive analysis was done in Stata version 15. The frequency and proportion were used to describe categorical variables, and the results were presented in frequency tables and graphs.
Ethical consideration
We obtained ethical clearance from the MUHAS research and publication committee with the certificate number of Ref. No. DA.282/298/01.C/. The participants voluntarily agreed to participate in this study by signing the informed consent form once the study objectives were well explained to them by the researchers. The women who lost their babies were counselled by the counsellors and midwives from health facilities before being interviewed in order to meet their social and psychological needs. However, the women who were aged 15-17, their guardians consented on their behalf in order to participate in the study after they agreed to participate in this study. The PDWs were interviewed privately in consultation rooms; the collected data were stored in well-secured computer devices with passwords and usernames; and the collected data or participants’ information were not shared with unauthorised individuals.
The study included 567 pregnant women (PDW) aged 15 to 44 years, with a 100% response rate. The participants’ average age was 25.77 years (SD = 5.86), with 461 (81.2%) falling between the ages of 21 and 35. Regarding education, 190 (33.5%) had completed primary school. Furthermore, 225 (39.7%) of the individuals were single. Over half of the women, 311 (54.8%), were in gestation 2 to 4, whereas 240 (42.3%) were nulliparous. Moreover, 291 (51.3%) of the participants lived in rural areas (Table 1).
The gestational age at the first antenatal care (ANC) visit ranged from 2 to 36 weeks, with a mean of 15.16 weeks (SD = 5.18). The majority, 392 (69.2%), reported starting ANC after 13 weeks of pregnancy. The gestational age at delivery ranged from 29 to 43 weeks, with an average of 38.12 weeks (SD = 2.05). The majority of participants, 392 (60.9%), gave birth between 38 and 42 weeks of gestation (Table 2).
A total of 258 CSs were performed across all six selected health facilities, of which 155(60.1%) were elective CSs; however, one hospital reported the highest elective CS rate of 12 out of 17 (70.5%) (Table 3). The previous caesarean scar was the most common indication for CS, accounting for 36 (19.3%) of all CS procedures performed (Table 4).
In terms of neonatal outcomes, six (2.3%) of the babies delivered via CS had an Apgar score of less than three at five minutes after birth. Four neonatal fatalities (1.6%) occurred after CS deliveries, and 84 (32.6%) of babies delivered via CS had post CS newborn complications within 72 hours of birth, where the most prevalent complication was early neonatal sepsis, which accounted for 34 (40.5%) of all newborns with complications after CS. In comparison, vaginal deliveries resulted in no neonatal deaths, but 4 (1.3%) of newborns had Apgar scores below 3 at five minutes, and 46 (14.9%) had complications, with early neonatal sepsis being the most common complication among vaginally delivered newborns, accounting for 19 (41.3%) of complications (Table 5).
Post-CS complications resulted in the admission of 33 (12.8%) of post-delivery women, where the most prevalent complications after CS were postpartum haemorrhage, 13 (39.4%) and postnatal infections, 10 (30.3%). For vaginal deliveries, 11 (3.6%) of women had post-delivery complications, with postpartum haemorrhage accounting for 6 (54.5%) of these (Table 6).
This study assessed the indications and outcomes of caesarean sections (CS) among women who delivered in health facilities in the Njombe region, Tanzania. The findings provide crucial insights into maternal and neonatal health, particularly the indications and outcomes of caesarean sections.
The majority of participants were between 21 and 35 years old, which is consistent with the reproductive age range in Tanzania and other low- and middle-income countries (LMICs) [1, 7]. The significant proportion of participants with primary education (33.5%) reflects regional educational attainment levels, which can influence access to maternal health care and comprehension of birth readiness [8]. Furthermore, over half of the participants resided in rural areas, emphasising the need for fair access to healthcare resources to address geographical discrepancies in obstetric care [9]. The majority of individuals began antenatal care (ANC) after 13 weeks of gestation, with an average gestational age of 15-16 weeks at the first ANC visit. This is consistent with national and regional trends demonstrating the late beginning of ANC services due to multiple hurdles, including lack of awareness, socio-cultural issues, and health system restrictions [10,11]. Early ANC initiation is crucial for monitoring maternal and fetal health and detecting difficulties for timely interventions [12].
The most common indications for CS were a previous caesarean scar, which aligns with global trends where past caesarean delivery often affects the method of subsequent deliveries. Elective CS accounted for the majority of procedures, indicating increased planning and access to obstetric care in the region [13]. However, there was the highest number of elective CS cases that lacked clinical indications in health facilities under study, emphasising potential misuse of CS, exposing women to avoidable surgical risks and straining healthcare resources [14,15].
Neonatal complications showed substantial disparities between CS and vaginal births. Neonatal complications were more prevalent in CS deliveries than in vaginal deliveries, with early neonatal sepsis being the most common complication in both types of deliveries. This is concurrent with the study, which was done in low- and middle-income countries (LMICs), newborn sepsis remains a substantial contributor to morbidity and mortality due to inadequate infection prevention efforts and limited neonatal care resources [16, 17]. There were only a few cases of newborn mortality that occurred during CS deliveries, highlighting the improved neonatal care services and decision-making in the region [18].
Postpartum haemorrhage (PPH) was the most common maternal complication after CS and vaginal deliveries; this is consistent with several studies, which highlight PPH as the leading cause of maternal morbidity and mortality worldwide. The findings emphasise the importance of appropriate prevention and management techniques during childbirth [19-21]. Postnatal infections were significantly higher among CS deliveries compared to vaginal deliveries, which is consistent with findings from other studies demonstrating a greater risk of infections following CS deliveries in resource-constrained settings [22, 23].
Strengths and Limitations
This study provides light on the indications and results of CS in a resource-limited situation. Since this was a descriptive cross-sectional study, we are not able to establish a link between the indications and outcomes of caesarean sections. As a result, we advocate for more analytical investigations to determine the association between indications and outcomes of caesarean sections.
What is already known about the topic
What this study adds
This study was partially supported by the United State President’s Emergency Plan for AIDS Relief (PEPFAR) through Centre for Excellence in Health Monitoring and Evaluation of Mzumbe University, Tanzania, with Grant Number NU2GGHOO2292 and granted to Jonhas Masatu. The funding was to support the data collection process.
Much appreciation to Muhimbili University of Health and Allied Sciences, Tanzania Field Epidemiology and Laboratory Training Program, for technical support, Dar es Salaam, Tanzania, Ministry of Health, Njombe Regional Medical Officer, Njombe Town Council, United States President Emergency Plan for AIDS Relief (PEPFAR) through Centre for Excellence in Health Monitoring and Evaluation of Mzumbe University Tanzania, for financial support, Makambako Town Council, and Wanging’ombe District Medical Officers for technical support during the data collection process.
Data availabity
The datasets collected and/or analyzed during the study are not publicly available due to privacy concerns, ethical constraints, and institutional policies, but can be obtained from the corresponding author upon reasonable request.
| Social demographic characteristics | Frequency (N=567) | Percentage (%) |
|---|---|---|
| Age (Years) | ||
| ≤20 | 70 | 12.4 |
| 21–35 | 461 | 81.2 |
| 36+ | 36 | 6.4 |
| Mother education level | ||
| No formal education | 135 | 23.8 |
| Primary | 190 | 33.5 |
| Secondary | 161 | 28.4 |
| College/University | 81 | 14.3 |
| Mother occupation | ||
| Subsistence farmers | 307 | 54.1 |
| Public & Private sectors employed | 35 | 6.2 |
| Petty business & self-employed | 225 | 39.7 |
| Marital status | ||
| Divorced | 87 | 15.3 |
| Single | 225 | 39.7 |
| Married | 102 | 18.0 |
| Widower | 153 | 27.0 |
| Residence | ||
| Rural | 291 | 51.3 |
| Urban | 276 | 48.7 |
| Council name | ||
| Njombe Town Council | 231 | 40.7 |
| Makambako Town Council | 183 | 32.3 |
| Wanging’ombe District Council | 153 | 27.0 |
| Health facility name | ||
| Njombe Town Hospital (Public) | 207 | 36.5 |
| Tanwat Hospital (Private) | 24 | 4.2 |
| St Joseph Hospital (Religious) | 83 | 14.6 |
| Ilembula Hospital (Religious) | 59 | 10.4 |
| Makambako Health Centre (Public) | 120 | 21.2 |
| Wanging’ombe Health Centre (Public) | 74 | 13.1 |
| Health facility level | ||
| Health Centers | 175 | 30.9 |
| Hospitals | 392 | 69.1 |
| Clinical characteristics | Frequency (N=567) | Percentage (%) |
|---|---|---|
| Gestation age during 1st ANC visit (weeks) | ||
| 0–12 | 175 | 30.9 |
| 13+ | 392 | 69.1 |
| Abortion history | ||
| Yes | 80 | 14.1 |
| No | 487 | 85.9 |
| Gestation age during labour (weeks) | ||
| 37 | 168 | 29.6 |
| 38–42 | 345 | 60.9 |
| 43+ | 54 | 9.5 |
| Maternal Height (cm) | ||
| ≤150 | 332 | 58.6 |
| 151+ | 235 | 41.4 |
| Had danger signs during pregnancy | ||
| Yes | 224 | 39.5 |
| No | 343 | 60.5 |
| Had previous caesarean scar(s) | ||
| Yes | 152 | 26.8 |
| No | 415 | 73.2 |
| Total ANC visits | ||
| ≤3 | 75 | 13.2 |
| 4+ | 492 | 86.8 |
| Sex of the baby | ||
| Male | 268 | 47.3 |
| Female | 286 | 50.4 |
| Unknown sex (Congenital disorders) | 13 | 2.3 |
| Number of babies born | ||
| Singleton | 528 | 93.1 |
| Twins | 39 | 6.9 |
| Birth Weight (kg) | ||
| ≤2.5 | 52 | 9.2 |
| 2.6–4.0 | 438 | 77.3 |
| 4.1+ | 77 | 13.5 |
| Health facility name | Health facility level | Total CS | Number of elective CS | Percentage (%) |
|---|---|---|---|---|
| Njombe Town Hospital | District Hospital | 70 | 44 | 62.8 |
| Makambako HC | Health Centre | 64 | 41 | 64.1 |
| Ilembula Hospital | Hospital at district level | 21 | 13 | 61.9 |
| St Joseph Hospital | Hospital at district level | 42 | 23 | 54.7 |
| Wanging’ombe HC | Health Centre | 44 | 22 | 50.0 |
| Tanawat Hospital | Hospital at district level | 17 | 12 | 70.5 |
| Total | 258 | 155 | 60.1 |
| Variables | Total CS | Percentage (%) |
|---|---|---|
| Number of CS | n=258 | 100 |
| Had CS indications | ||
| Yes | 187 | 72.5 |
| No | 71 | 27.5 |
| Common indications for CS* | ||
| Placental abruption | 3 | 1.6 |
| Other indications** | 4 | 2.1 |
| Placenta previa | 4 | 2.1 |
| Multiple pregnancy | 5 | 2.7 |
| Post-term labour | 6 | 3.2 |
| Prolonged labour | 7 | 3.7 |
| Cephalopelvic disproportion | 9 | 4.8 |
| Obstructed labour | 10 | 5.3 |
| Big baby | 12 | 6.4 |
| Transverse lie | 13 | 7.0 |
| Severe eclampsia | 14 | 7.5 |
| Cord prolapse | 15 | 8.0 |
| Malpresentation | 16 | 8.6 |
| Fetal distress | 33 | 17.6 |
| Previous caesarean scar | 36 | 19.3 |
| * Indications for CS (n=187); ** Other indications (uterine rupture, placenta accreta, and fetal abnormalities). | ||
| Newborn outcomes after delivery | Caesarean sections | Vaginal deliveries | ||
|---|---|---|---|---|
| Frequency (n=258) | Percentage (%) | Frequency (n=309) | Percentage (%) | |
| Stillbirths | 4 | 1.6 | 0 | 0.0 |
| Live births: Apgar score at 5 minutes | ||||
| 1–3 | 6 | 2.3 | 4 | 1.3 |
| 4–6 | 24 | 9.8 | 42 | 13.6 |
| 7–10 | 224 | 86.8 | 263 | 85.1 |
| Had live newborns post-delivery complications | ||||
| Yes | 84 | 32.6 | 46 | 14.9 |
| No | 174 | 67.4 | 263 | 85.1 |
| Common newborn complications | *** | **** | ||
| Birth asphyxia | 1 | 1.2 | 1 | 2.2 |
| Respiratory distress | 3 | 3.5 | 1 | 2.2 |
| Meconium aspiration syndrome | 5 | 6.0 | 1 | 2.2 |
| Hypoglycemia | 5 | 6.0 | 1 | 2.2 |
| Hypothermia | 7 | 8.3 | 3 | 6.5 |
| Neurological complications | 11 | 13.1 | 10 | 21.7 |
| Early neonatal jaundice | 18 | 21.4 | 10 | 21.7 |
| Early neonatal sepsis | 34 | 40.5 | 19 | 41.3 |
| *** Newborn complications after CS (n=84). **** Newborn complications after vaginal delivery (n=46). | ||||
| Maternal outcomes after delivery | Caesarean sections | Vaginal deliveries | ||
|---|---|---|---|---|
| Frequency (n=258) | Percentage (%) | Frequency (n=309) | Percentage (%) | |
| Had maternal post-delivery complications | ||||
| Yes | 33 | 12.8 | 11 | 3.6 |
| No | 225 | 87.2 | 298 | 96.4 |
| Common maternal post-delivery complications* | ||||
| Postnatal psychosis | 1 | 3.0 | 0 | 0.0 |
| Anesthetic complications | 1 | 3.0 | 0 | 0.0 |
| Severe anemia | 3 | 9.1 | 1 | 9.1 |
| Pulmonary embolism | 5 | 15.2 | 2 | 18.2 |
| Postnatal infections | 10 | 30.3 | 2 | 18.2 |
| Postpartum hemorrhage | 13 | 39.4 | 6 | 54.5 |
| * Maternal complications after CS (n=33); Maternal complications after vaginal delivery (n=11). | ||||