Caesarean Deliveries in Internally Displaced Parturients at a Tertiary Hospital in Sub-Saharan Africa: A Five-Year Robson-Based Review.

Abstract

Background: Caesarean section (CS) is a common but important obstetric procedure that saves maternal and neonatal lives when complications occur. However, rising CS rates, especially among vulnerable populations such as internally displaced persons (IDPs), raise concerns about appropriate use, equity, and outcomes. Aim: This study aimed to assess the frequency, pattern, and outcomes of caesarean deliveries among IDP women in a tertiary hospital in sub-Saharan Africa using the Robson Ten-Group Classification System. Methodology: A retrospective, descriptive study was conducted at Benue State University Teaching Hospital, Nigeria, Sub-Saharan Africa, over a five-year period (March 2018 to February 2023). Data were obtained from clinical records of 167 IDP women who underwent CS. Deliveries were categorised using the Robson classification. Maternal, foetal, and obstetric characteristics were analysed using descriptive statistics. Results: The mean age of respondents was 27.3 ± 6.3 years. Most were multiparous (88.0%), married (94.6%), and engaged in farming (74.9%). Only 13.2% were booked for antenatal care. Robson group 3 (multiparous, term, spontaneous labour, no previous CS) was the largest contributor to overall CS (26.3%), followed by group 5 (multiparous with previous CS; 19.2%) and group 7 (multiparous breech; 18.5%). The overall CS rate was 46.5%. Most patients (91.0%) had no postpartum complications. Live births accounted for 87.4% of deliveries, while 10.2% were stillbirths and 2.4% early neonatal deaths. APGAR scores at the 5th minute were ≥7 in 88.5% of cases. Conclusion: The CS rate among IDP women was high, with Robson group 3 contributing the most, even though composed of women often considered low-risk. These findings show the importance of close monitoring in labour, antenatal care and audit systems to improve outcomes in displaced populations.