Preference and Actual Mode of Delivery, Complication and Outcome of Pregnancy among Women in a Tertiary Hospital of Bangladesh.

Pregnancy and childbirth involve multiple decisions and uncertainties. A woman's preferred mode of delivery may not always match the actual mode she experiences. This difference can have important implications for the occurrence of complications and the eventual outcomes for both mother and baby. This study aimed to identify women's preferred and actual modes of delivery, examine the relationship between antenatal or obstetric complications and delivery mode and find out the maternal and neonatal outcomes among women. The cross-sectional descriptive type of observational study was carried out in the in-patient department of Obstetrics and Gynaecology of Mymensingh Medical College Hospital (MMCH), Bangladesh during the period of November 2024 to April 2025. Data were collected from purposively selected 402 women who gave childbirth in MMCH, using a pre-tested case record form. Interview, clinical examinations and necessary investigations were done. Data were analyzed by computer software, SPSS, version 22.0. A total of 402 women were enrolled in this study. Most of them 281(70.0%) were between 18 and 27 years old, with a mean age of 25.0±4.994 years. The majority was housewives 348(86.6%) and came from rural areas (68.4%). Although most women 321(79.9%) expected to have a normal vaginal delivery (NVD), more than three-fourths 307(76.4%) ultimately underwent a lower uterine caesarean section (LUCS). Proportion of LUCS was 76.4%. It was found that 226(70.4%) women who expected NVD had to undergo LUCS and this difference between expected and actual mode of delivery was statistically significant (p<0.001). The most common reason for caesarean delivery was a previous caesarean section 145(47.2%), followed by severe preeclampsia 34(11.1%) and antepartum haemorrhage 26(8.5%). Overall, most of the babies 301(74.9%) were born healthy. However, some experienced complications, including low birth weight 35(8.7%), birth asphyxia 25(6.2%) and stillbirth 18(4.5%).