‘The Preferred Option’: C-Sections and Bangladeshi Women’s Navigation of Fear, Responsibility, and Care in Childbirth

In 2022, caesarean section (CS) rate in Bangladesh was among the highest globally, at 45%. Referred to by research interlocutors as the safe (nirapod), ‘preferred’ option, CS is paradoxically experienced as a life-long khoto (wound). By tracing the colonial and postcolonial trajectory of CS, this mixed-methods dissertation examines the experiences of Bangladeshi women in pre-CS and post-CS contexts across socio-economic, educational, and spatial contexts in Dhaka (capital city) and Sylhet (north-eastern city).

This research integrates online surveys with digital ethnographic methods, including remote interviews and focus groups with women, their spouses, senior female relatives, and healthcare providers. Quantitative findings indicate that nearly half of respondents underwent elective caesareans, most citing medical advice.

The study engages scholarship on the anthropology of reproduction, biomedicalisation of birth, reproductive governance, authoritative knowledge, complex iatrogenesis, risk, uncertainty, and responsibility. My qualitative research extends this literature by distinctively showing that family decision-making about CS embodies risk, bhoy (fear), dor (anxiety), nirapod (safety) and onishchoyota (uncertainty) related to childbirth, reinforced by the framing of CS as nirapod (risk-free). It highlights internalisation and distribution of responsibility among women, through which futurity of responsibility, linked to prevention and precaution, is presented. This also brings to the surface passive agency among women undergoing CS at the same heteronormative and patriarchal juncture.

This study is timely amid rising global CS rates and concerns about how commercialised private healthcare and institutional logics shape reproduction in the Global South. The urgency lies in the rapid rise of institutional births (nearly 64%), where 69% are CS, rising to 85% in private facilities, often without medical indication, creating financial strain for families. CS is no longer only a medical event but a familial, political and commercial phenomenon with major public health implications. This study shows how women negotiate this complex terrain of CS.