@article{fdi:010080607,
  title = {{W}omen's empowerment and elective cesarean section for a single pregnancy : a population-based and multivariate study in {V}ietnam},
  author = {{L}oenzien, {M}yriam de and {M}ac, {Q}. {N}. {H}. and {D}umont, {A}lexandre},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground {W}omen's empowerment, and maternal and neonatal health are important targets of the {S}ustainable {D}evelopment {G}oals. {O}ur objective is to examine the relationship between women's empowerment and elective cesarean section ({ECS}), focusing on {V}ietnam, a country where the use of {CS} has increased rapidly in recent decades, which raises public health concerns. {M}ethods {W}e hypothesized that in the context of the developing biomedicalization of childbirth, women's empowerment increases the use of {ECS} due to a woman's enhanced ability to decide her mode of delivery. {B}y using microdata from the 2013-2014 {M}ultiple {I}ndicator {C}lusters {S}urvey, we conducted a multivariate analysis of the correlates of {ECS}. {W}e studied a representative sample of 1343 institutional single birth deliveries. {D}ue to higher {ECS} rates among multiparous (18.4%) than primiparous women (10.1%) and the potential interaction between parity and other correlates, we used separate models for primiparous and multiparous women. {R}esults {A}mong the indicators of women's external resources, which include a higher level of education, having worked during the previous 12 months, and having one's own mobile phone, only education differed between primiparous and multiparous women, with a higher level among primiparous women. {A}mong primiparous women, no resource indicator was significantly linked to {ECS}. {H}owever, considering women's empowerment facilitated the identification of the negative impact of having had fewer than 3 antenatal care visits on the use of {ECS}. {A}mong multiparous women, disapproval of intimate partner violence ({IPV}) was associated with a doubled likelihood of undergoing {ECS} (odds ratio = 2.415), and living in an urban area also doubled the likelihood of {ECS}. {T}he positive association with living in the richest household quintile was no longer significant when attitude towards {IPV} was included in the model. {I}n both groups, being aged 35 or older increased the likelihood of undergoing {ECS}, and this impact was stronger in primiparous women. {C}onclusions {T}hese results underline the multidimensionality of empowerment, its links to other correlates and its contribution to clarifying the influence of these correlates, particularly for distinguishing between medical and sociocultural determinants. {T}he results advocate for the integration of women's empowerment into policies aimed at reducing {ECS} rates.},
  keywords = {{C}hildbirth ; women s empowerment ; cesarean section ; {V}ietnam ; logistic regression analysis ; parity ; biomedicalization ; population ; {VIET} {NAM}},
  booktitle = {},
  journal = {{BMC} {P}regnancy and {C}hildbirth},
  volume = {21},
  numero = {1},
  pages = {3 [12 ]},
  year = {2021},
  DOI = {10.1186/s12884-020-03482-x},
  URL = {https://www.documentation.ird.fr/hor/fdi:010080607},
}