Prevalence, Indications, and Immediate Fetal and Maternal Outcomes of Cesarean Section Among Primigravida Delivered at BMC, Mwanza, Tanzania

Cesarean section (CS) rates have been steadily increasing worldwide beyond medical needs. Globally, CS rates have surpassed the World Health Organization's recommended 10–15% range, with potential implications for maternal and neonatal health. The first mode of delivery influences future pregnancies. This study aimed to determine the prevalence, indications, and immediate fetal and maternal outcomes of cesarean section among primigravida women delivered at Bugando Medical Centre (BMC), Mwanza, Tanzania, from January 2022 to 2025. A retrospective cross-sectional study reviewed the medical records of 868 primigravida women who underwent CS during the study period. Data was extracted from the Electronic Health Management System and analyzed using descriptive statistics and inferential tests in SPSS version 26. The prevalence of CS among primigravida deliveries was 25% (868/3,515). Most women were aged 20–34 years (87.3%), delivered at term (83.9%), and underwent emergency CS (94.6%). The leading maternal indication was prolonged/obstructed/poor progress of labor (63.4%), while fetal indications included fetal distress/non-reassuring fetal status (14.2%). Maternal outcomes showed no complications in 75.7% of cases, with PPH (12.7%) as the most common issue. Neonatal outcomes included normal birth weight in 86.0%, NICU admission in 15.8% (primarily due to respiratory distress syndrome [37%]). Prevalence of CS in primigravida at BMC is higher than WHO range, mainly driven by labor-related maternal indications. No immediate complications to mother and child highlight the safe nature of CS.