Time to Recovery After Cesarean Section Delivery and its Predictors in Butajira and Attat Hospitals, South Ethiopia: A Prospective Cohort Study

Background: Although Cesarean delivery is a marker for the availability and use of obstetric services, the risks related to it cannot yet be clearly defined. But the hazards can be minimized by avoiding unnecessary operations, meticulous attention to proper anesthetic and surgical techniques and by providing necessary post-operative cares. The aim of this assessment is to identify whether the women recover timely or not and its predictors as these two institutions are the only hospitals in the area which perform cesarean section. Methods: A prospective cohort study was employed among 400 women who gave birth by cesarean section. Data was cleaned and entered by Epi info version 7 and analyzed by SPSS version 20. Cox- proportional hazard regression model was built and variables that had P-value < 0.25 in bivariate analysis were considered for the candidates of multivariate analysis to determine independent predictors of timely recovery by using P-value < 0.05. Results: Randomly selected 400 mothers were followed for 1285 person day of observation. During the follow up 386 women have timely recovery; hence, the overall incidence density rate (IDR) of timely recovery in the cohort was 0.3 per Person-day which is equal to 2.1 per person week. The research uncovered that the rate of timely recovery (within 4 days) was 96.5%. Survival at the end of 1st, 2nd, 3rd and 4th day was 87%, 82.5%, 46.5% and 3.5% respectively and the overall mean survival time was 3.27(95%CI: 3.15-3.39) days. Having a normal weight, term gestation, early initiation of mobilization, having regional anesthesia and transverse cesarean section were associated with timely recovery. Conclusion and recommendation: The finding was in acceptable range, however, to improve timely recovery in further better position, preoperative maternal status, intraoperative follow up and post-operative care is needed.