Abstract:
Background: Spontaneous vaginal delivery (SVD) is preferred for its health benefits, but
maternal choices and medical factors influence its prevalence. Rising cesarean rates highlight the
need to understand deviations from planned SVD.
Objective: To investigate the associated factors influencing the choice of SVD and deviation from
planned SVD among mothers admitted for childbirth at Kahawatta Base Hospital, Ratnapura, Sri
Lanka
Methods: A descriptive cross-sectional study, was conducted among 120 postnatal mothers,
recruited through convenience sampling. Data was collected through an interviewer-administered
questionnaire, developed based on previous literature. Data was analysed using SPSS version
25.0, and Chi-square test was used to assess associations.
Results: The majority of the mothers were aged 26-35 years (74.2%, n=89) (mean±SD;
31.42±4.65), married (90.8%, n=109), and had education up to the Ordinary Level (72.5%, n=87).
The Most resided in rural areas (65.0%, n=78) and were unemployed (84.2%, n=101). Most
deliveries occurred at >37 weeks gestation (59.2%, n=71), with newborns weighing between 2.5-
3.5 kg. Of 120 mothers, 35.8% (n=43) of deliveries deviated from planned SVD to LSCS (30.8%,
n=37) and instrumental delivery (5.0%, n=6). The Chi-square test results showed significant
associations between ethnicity (p=0.018) and occupation (p=0.012) with the choice of mode of
delivery. Moreover, obstetric history of antepartum hemorrhage and post-partum hemorrhage
(p=0.022) and presentation of liquor (p=0.007) were significantly associated with the deviation
from planned SVDs.
Conclusion: Ethnicity and occupation significantly influence the mode of delivery, highlighting
the need for culturally sensitive and employment-focused maternal healthcare strategies. It is
recommended to strengthen antenatal care by identifying high-risk mothers early and providing
targeted counseling on delivery options. Enhancing maternal education and improving access to
timely obstetric interventions, especially in rural areas, can reduce unplanned deviations and
promote safer birthing outcomes.
