1 Data

2 Check columns

## Rows: 187
## Columns: 28
## $ age            <chr> "30–34", "<20", "<20", "20–24", "25–29", "25–29", "25–2…
## $ accom          <chr> "Upazila Sadar", "Upazila Sadar", "Village", "Village",…
## $ edu            <chr> "Higher Secondary", "Primary", "Bachelor's degree or ab…
## $ occ            <chr> "Other", "Worker", "Housewife", "Housewife", "Employee"…
## $ ses            <chr> "High", "Medium", "Medium", "Medium", "High", "Low", "M…
## $ parity         <chr> "2nd", "3rd", "≥4", "1st", "2nd", "≥4", "2nd", "2nd", "…
## $ prev_cs        <chr> NA, "No", "No", "No", "Yes", "No", "Yes", "Yes", "No", …
## $ prev_cs_no     <chr> "≥3 times", "1 time", "≥3 times", NA, "1 time", "≥3 tim…
## $ ga             <chr> ">40 weeks (Post-term)", "37–40 weeks (Term)", ">40 wee…
## $ med_comp       <chr> "There were no complications.", "High blood pressure/pr…
## $ req_lucs       <chr> "Not sure.", "Yes", "No", "No", "Yes", "No", "No", "Yes…
## $ cs_ind         <chr> "Obstructed labour", "Previous cesarean", "Previous ces…
## $ del_type       <chr> "Elective", "Elective", "Emergency", "Emergency", "Elec…
## $ fd_dx          <chr> "Meconium-stained liquor", "CTG findings", "Meconium-st…
## $ labor_on       <chr> "Yes, long/interrupted", "Labor has not started.", "Yes…
## $ neo_out        <chr> "Alive and well", "NICU admission required", "Dead (sti…
## $ bw_g           <chr> "2500–3499", "≥3500", "<2500", "<2500", "2500–3499", "2…
## $ apgar1         <chr> "4-6", "7-10", "4-6", "4-6", "7-10", "4-6", "7-10", "7-…
## $ apgar5         <chr> "4-6", "7-10", "<3", "4-6", "7-10", "4-6", "7-10", "7-1…
## $ dec_maker      <chr> "Resident/Trainee Doctor", "Due to patient/family press…
## $ dti_time       <chr> "<30 minutes", "<30 minutes", "30–60 minutes", "<30 min…
## $ surgeon        <chr> "Consultant", "Consultant", "Consultant", "Registrar", …
## $ ot_support     <chr> "24 hours OT available", "Anesthetist present", "Anesth…
## $ cs_sop         <chr> "Yes, written.", "No", "Yes, oral", "Yes, written.", "Y…
## $ med_legal      <chr> "Yes", "Not sure.", "No", "Not sure.", "Not sure.", "No…
## $ train_cs       <chr> "Yes", "Partially", "No", "No", "No", "No", "No", "Yes"…
## $ pt_req_cs      <chr> "Yes", "Yes", "Yes", "No", "Yes", "Yes", "No", "Yes", "…
## $ workload_press <chr> "No effect", "No effect", "No effect", "No effect", "Sh…
##  [1] "age"            "accom"          "edu"            "occ"           
##  [5] "ses"            "parity"         "prev_cs"        "prev_cs_no"    
##  [9] "ga"             "med_comp"       "req_lucs"       "cs_ind"        
## [13] "del_type"       "fd_dx"          "labor_on"       "neo_out"       
## [17] "bw_g"           "apgar1"         "apgar5"         "dec_maker"     
## [21] "dti_time"       "surgeon"        "ot_support"     "cs_sop"        
## [25] "med_legal"      "train_cs"       "pt_req_cs"      "workload_press"
## Rows: 28
## Columns: 3
## $ no             <dbl> 1.0, 2.0, 3.0, 4.0, 5.0, 6.0, 7.0, 8.0, 9.0, 10.0, 11.0…
## $ full_indicator <chr> "Patient's age (years)", "Accommodation", "Educational …
## $ short_form     <chr> "Age", "Accom", "Edu", "Occ", "SES", "Parity", "Prev_CS…
## [1] "no"             "full_indicator" "short_form"

3 Prepare variable labels from data dictionary

4 Univariate table

Characteristic N = 1871
Patient's age (years)
    <20 33 (18%)
    ≥35 9 (4.8%)
    20–24 48 (26%)
    25–29 65 (35%)
    30–34 31 (17%)
    Unknown 1
Accommodation
    City 44 (24%)
    Other 20 (11%)
    Upazila Sadar 46 (25%)
    Village 76 (41%)
    Unknown 1
Educational Qualifications
    Bachelor's degree or above 15 (8.0%)
    Higher Secondary 26 (14%)
    Illiterate 28 (15%)
    Primary 48 (26%)
    Secondary 70 (37%)
Profession
    Employee 65 (35%)
    Housewife 51 (27%)
    Other 7 (3.8%)
    Student 41 (22%)
    Worker 22 (12%)
    Unknown 1
Economic status (self-reported)
    High 30 (16%)
    Low 57 (30%)
    Medium 100 (53%)
Pregnancy number (Parity)
    ≥4 13 (7.0%)
    1st 56 (30%)
    2nd 56 (30%)
    3rd 62 (33%)
Previous cesarean section 86 (46%)
    Unknown 2
Number of previous CS
    ≥3 times 15 (10%)
    1 time 55 (37%)
    2 times 77 (52%)
    Unknown 40
Current gestational age
    <37 weeks (Preterm) 78 (42%)
    >40 weeks (Post-term) 17 (9.2%)
    37–40 weeks (Term) 89 (48%)
    Unknown 3
Medical complications
    Diabetes mellitus 42 (23%)
    Heart disease 17 (9.1%)
    High blood pressure/pre-eclampsia 44 (24%)
    Other 13 (7.0%)
    Severe anemia 55 (30%)
    There were no complications. 15 (8.1%)
    Unknown 1
Patient wanted LUCS in advance
    No 74 (40%)
    Not sure. 28 (15%)
    Yes 84 (45%)
    Unknown 1
Main indication for current CS
    Fetal distress 31 (17%)
    Malpresentation (breech/transverse) 20 (11%)
    Maternal complications (PIH/DM etc.) 17 (9.1%)
    Obstructed labour 41 (22%)
    Other 3 (1.6%)
    Patient's wish (elective on request) 12 (6.5%)
    Placenta previa / abruption 14 (7.5%)
    Previous cesarean 33 (18%)
    Twin/multiple pregnancy 15 (8.1%)
    Unknown 1
Delivery type
    Elective 80 (43%)
    Emergency 106 (57%)
    Unknown 1
Fetal distress diagnosis
    CTG findings 37 (20%)
    FHR auscultation 73 (39%)
    Meconium-stained liquor 58 (31%)
    Other 17 (9.2%)
    Unknown 2
Labor underway
    Induction failed 43 (23%)
    Labor has not started. 28 (15%)
    Yes, long/interrupted 67 (36%)
    Yes, naturally. 46 (25%)
    Unknown 3
Neonatal outcomes
    Alive and well 71 (38%)
    Dead (stillbirth/perinatal) 30 (16%)
    NICU admission required 86 (46%)
Birth weight (grams)
    <2500 52 (28%)
    ≥3500 24 (13%)
    2500–3499 109 (59%)
    Unknown 2
Apgar Score @1 min
    <3 27 (15%)
    4-6 109 (59%)
    7-10 49 (26%)
    Unknown 2
Apgar Score @5 min
    <3 23 (12%)
    4-6 88 (47%)
    7-10 76 (41%)
CS decision maker
    Consultant (OBGYN Specialist) 52 (28%)
    Due to patient/family pressure 29 (16%)
    Resident/Trainee Doctor 66 (35%)
    Team Decision 39 (21%)
    Unknown 1
Decision–to–Incision time
    <30 minutes 59 (32%)
    >60 minutes 19 (10%)
    30–60 minutes 109 (58%)
Operator
    Consultant 60 (32%)
    Medical Officer/Trainee 39 (21%)
    Other 18 (9.6%)
    Registrar 70 (37%)
OT preparation & support
    24 hours OT available 58 (32%)
    Anesthetist present 73 (40%)
    Blood bank ready 33 (18%)
    The newborn team is ready. 20 (11%)
    Unknown 3
Written SOPs for CS
    No 23 (12%)
    Yes, oral 82 (44%)
    Yes, written. 81 (44%)
    Unknown 1
Medico-legal influence
    No 105 (56%)
    Not sure. 29 (16%)
    Yes 53 (28%)
Training / apprenticeship CS
    No 103 (55%)
    Partially 25 (13%)
    Yes 59 (32%)
Patient/family request CS 121 (65%)
    Unknown 1
Workload/resource pressure
    No effect 113 (61%)
    Short 72 (39%)
    Unknown 2
1 n (%)

5 Bivariate table

Characteristic Elective
N = 801		 Emergency
N = 1061		 p-value2
Patient's age (years)

0.2
    <20 8 (10%) 25 (24%)
    ≥35 5 (6.3%) 4 (3.8%)
    20–24 22 (28%) 25 (24%)
    25–29 32 (40%) 33 (31%)
    30–34 13 (16%) 18 (17%)
    Unknown 0 1
Accommodation

0.13
    City 14 (18%) 30 (29%)
    Other 12 (15%) 8 (7.6%)
    Upazila Sadar 23 (29%) 23 (22%)
    Village 31 (39%) 44 (42%)
    Unknown 0 1
Educational Qualifications

0.014
    Bachelor's degree or above 11 (14%) 4 (3.8%)
    Higher Secondary 16 (20%) 10 (9.4%)
    Illiterate 9 (11%) 19 (18%)
    Primary 20 (25%) 28 (26%)
    Secondary 24 (30%) 45 (42%)
Profession

0.2
    Employee 34 (43%) 30 (29%)
    Housewife 16 (20%) 35 (33%)
    Other 4 (5.0%) 3 (2.9%)
    Student 16 (20%) 25 (24%)
    Worker 10 (13%) 12 (11%)
    Unknown 0 1
Economic status (self-reported)

0.047
    High 19 (24%) 11 (10%)
    Low 21 (26%) 35 (33%)
    Medium 40 (50%) 60 (57%)
Pregnancy number (Parity)

0.4
    ≥4 6 (7.5%) 7 (6.6%)
    1st 19 (24%) 36 (34%)
    2nd 24 (30%) 32 (30%)
    3rd 31 (39%) 31 (29%)
Previous cesarean section 38 (48%) 48 (46%) 0.9
    Unknown 1 1
Number of previous CS

0.058
    ≥3 times 10 (15%) 5 (6.3%)
    1 time 19 (29%) 36 (45%)
    2 times 37 (56%) 39 (49%)
    Unknown 14 26
Current gestational age

0.10
    <37 weeks (Preterm) 27 (34%) 50 (49%)
    >40 weeks (Post-term) 10 (13%) 7 (6.8%)
    37–40 weeks (Term) 43 (54%) 46 (45%)
    Unknown 0 3
Medical complications

0.019
    Diabetes mellitus 21 (26%) 21 (20%)
    Heart disease 7 (8.8%) 9 (8.6%)
    High blood pressure/pre-eclampsia 11 (14%) 33 (31%)
    Other 4 (5.0%) 9 (8.6%)
    Severe anemia 26 (33%) 29 (28%)
    There were no complications. 11 (14%) 4 (3.8%)
    Unknown 0 1
Patient wanted LUCS in advance

0.4
    No 28 (35%) 46 (44%)
    Not sure. 14 (18%) 13 (12%)
    Yes 38 (48%) 46 (44%)
    Unknown 0 1
Main indication for current CS

0.2
    Fetal distress 10 (13%) 21 (20%)
    Malpresentation (breech/transverse) 11 (14%) 9 (8.6%)
    Maternal complications (PIH/DM etc.) 9 (11%) 7 (6.7%)
    Obstructed labour 15 (19%) 26 (25%)
    Other 2 (2.5%) 1 (1.0%)
    Patient's wish (elective on request) 9 (11%) 3 (2.9%)
    Placenta previa / abruption 7 (8.8%) 7 (6.7%)
    Previous cesarean 11 (14%) 22 (21%)
    Twin/multiple pregnancy 6 (7.5%) 9 (8.6%)
    Unknown 0 1
Fetal distress diagnosis

0.010
    CTG findings 8 (10%) 29 (27%)
    FHR auscultation 30 (38%) 43 (41%)
    Meconium-stained liquor 31 (39%) 27 (25%)
    Other 10 (13%) 7 (6.6%)
    Unknown 1 0
Labor underway

<0.001
    Induction failed 25 (31%) 17 (17%)
    Labor has not started. 21 (26%) 7 (6.8%)
    Yes, long/interrupted 22 (28%) 45 (44%)
    Yes, naturally. 12 (15%) 34 (33%)
    Unknown 0 3
Neonatal outcomes

0.7
    Alive and well 28 (35%) 43 (41%)
    Dead (stillbirth/perinatal) 14 (18%) 16 (15%)
    NICU admission required 38 (48%) 47 (44%)
Birth weight (grams)

<0.001
    <2500 9 (12%) 42 (40%)
    ≥3500 19 (24%) 5 (4.7%)
    2500–3499 50 (64%) 59 (56%)
    Unknown 2 0
Apgar Score @1 min

0.8
    <3 10 (13%) 17 (16%)
    4-6 47 (59%) 62 (59%)
    7-10 22 (28%) 26 (25%)
    Unknown 1 1
Apgar Score @5 min

0.3
    <3 12 (15%) 11 (10%)
    4-6 33 (41%) 55 (52%)
    7-10 35 (44%) 40 (38%)
CS decision maker

0.024
    Consultant (OBGYN Specialist) 20 (25%) 32 (30%)
    Due to patient/family pressure 20 (25%) 9 (8.6%)
    Resident/Trainee Doctor 24 (30%) 41 (39%)
    Team Decision 16 (20%) 23 (22%)
    Unknown 0 1
Decision–to–Incision time

0.3
    <30 minutes 22 (28%) 37 (35%)
    >60 minutes 11 (14%) 8 (7.5%)
    30–60 minutes 47 (59%) 61 (58%)
Operator

0.4
    Consultant 21 (26%) 38 (36%)
    Medical Officer/Trainee 16 (20%) 23 (22%)
    Other 10 (13%) 8 (7.5%)
    Registrar 33 (41%) 37 (35%)
OT preparation & support

0.7
    24 hours OT available 23 (29%) 35 (34%)
    Anesthetist present 31 (39%) 42 (41%)
    Blood bank ready 17 (21%) 15 (15%)
    The newborn team is ready. 9 (11%) 11 (11%)
    Unknown 0 3
Written SOPs for CS

0.2
    No 13 (16%) 10 (9.4%)
    Yes, oral 36 (46%) 45 (42%)
    Yes, written. 30 (38%) 51 (48%)
    Unknown 1 0
Medico-legal influence

0.038
    No 45 (56%) 60 (57%)
    Not sure. 18 (23%) 11 (10%)
    Yes 17 (21%) 35 (33%)
Training / apprenticeship CS

0.3
    No 43 (54%) 59 (56%)
    Partially 14 (18%) 11 (10%)
    Yes 23 (29%) 36 (34%)
Patient/family request CS 53 (66%) 67 (64%) 0.9
    Unknown 0 1
Workload/resource pressure

>0.9
    No effect 48 (61%) 64 (61%)
    Short 31 (39%) 41 (39%)
    Unknown 1 1
1 n (%)
2 Pearson’s Chi-squared test