Jamesville, New York: A new study published in the Howard Journal of Communications suggests that the rising rate of cesarean section births in Bangladesh may not be explained by doctors and hospitals alone. The study finds that social influence, family expectations, cultural beliefs, and ideas about modern childbirth may also shape women’s intentions toward cesarean section, commonly known as CS.

The article, “Cultural Norms and Maternal Health Behavior: Social Influences on Cesarean Section Intentions in Bangladesh,” was authored by Jamal Uddin, Faculty Research Fellow at the Center for South Asian Media and Culture and a former faculty member at Cornell University. It was published online on September 2, 2026.

Cesarean section can save lives when it is medically necessary. However, Bangladesh has seen a sharp rise in CS births, especially in private hospitals. Studies have reported CS rates as high as 84% in mostly private facilities, far above the World Health Organization’s historically cited 10%–15% range. In this study, 85% of private-hospital deliveries were CS, compared with 46% in public hospitals. This has raised serious concerns about unnecessary procedures, women’s health, and the financial burden on families.

The study surveyed 503 Bangladeshi women aged 18 to 35 who had given birth within the previous two years. Using two health behavior theories, the Health Belief Model and the Theory of Planned Behavior, the study examined how women’s health beliefs, social expectations, sense of control, and healthcare provider influence shaped their CS intentions. The final statistical model included 350 women with CS experience.

One key finding was that many women who had a CS did not initially prefer it. The study found that 91% of women who underwent CS had not initially preferred cesarean delivery. Yet, social norms were the strongest predictor of CS intention.

The study points to several social beliefs that may influence CS decisions: the idea that “everyone is doing CS now,” the desire to avoid the pain of vaginal delivery, positive CS experiences among family members, trust in technology-assisted childbirth, and the perception that CS is connected with higher social or economic status.

“This study shows that cesarean section decisions are not only medical decisions,” said Jamal Uddin. “They are also shaped by family, culture, social expectations, and how people understand safe and modern childbirth.”

The study does not argue that doctors and hospitals are unimportant. Instead, it suggests that doctors’ advice may work within a larger social environment where family members, fear, hospital practices, social status, and limited access to reliable information all matters.

The findings suggest that reducing unnecessary CS in Bangladesh may require more than educating pregnant women alone. Public health efforts should also include husbands, mothers, mothers-in-law, and other influential family members. The study also recommends reliable Bengali-language maternal health information, stronger physician-patient communication, better provider training, and routine monitoring of hospital CS rates.

In simple terms, reducing unnecessary CS requires more than medical advice. It also requires better communication with families, stronger public awareness, and attention to the cultural beliefs shaping childbirth decisions.