Abstract

Background: Better maternal and perinatal outcomes can be ensured through essential obstetric and newborn care provided by skilled attendants during pregnancy and childbirth. In many resource-poor settings, access to skilled care and crucial interventions is limited. Cesarean delivery is a marker for the availability and use of obstetric services in this situation. A number of factors have been found to make it more likely that a cesarean section will be chosen, but the risks cannot yet be clearly defined. The aim of this assessment is to determine recovery situation after cesarean surgery and associated factors in governmental and Non-governmental hospitals of Gurage Zone.

Methods: A prospective cohort study was employed among a total of 400 women who gave birth by cesarean section in Attat and Butajira Hospitals with in the follow up period. Data was collected using standardized checklist and interview questioner by trained professionals through reviewing records and interviews. 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 considered candidates for multivariate analysis to determine independent predictors of timely recovery by using P-value < 0.05. Finally, the result was presented using descriptive statement, tables, and figure that is compared with similar studies elsewhere.

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 patients.  The rate of timely recovery (within 4 days) is 96.5%.  Survival at the end of 1^st, 2^nd, 3^rd, and 4^th 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 associated with timely recovery after cesarean section.

Conclusion and recommendation: The rate of timely recovery (within 4 days) is 96.5%. Usually it is expected that mothers will recover within 3-4 days after having cesarean section delivery and is in acceptable range. However, to improve timely recovery in the best position, hospital managers and professionals need to work in improving preoperative maternal status, intraoperative follow up and post-operative care.

Key words: recovery after cesarean section, associated factors, Butajira and, Attat hospital