Knowledge and Positive Attitudes toward Caesarean Section Delivery among Married Women in Bangladesh

Background Caesarean section (CS) rates in Bangladesh have increased rapidly in recent decades. This increase raises concerns about unnecessary procedures and their potential impacts on maternal health. Women’s knowledge and positive attitudes toward CS influence delivery preferences and decisions, yet these aspects remain underexplored in Bangladesh. Objectives To assess knowledge and positive attitudes toward CS and to identify factors associated with knowledge and positive attitudes among married women in Bangladesh. Methods The study utilized a cross-sectional sample of married women of reproductive age. A structured questionnaire was used in face-to-face interviews to collect data covering socio-demographic information, obstetric experiences, knowledge, and positive attitudes toward CS. Descriptive statistics, independent sample t-tests, and multiple linear regression analysis were performed to identify factors. Results This study showed that knowledge was lower among rural than urban women; lower among women with a previous CS than those without, and higher among women from husband-headed households. Additionally, respondents without an income source had higher knowledge than those with an income. Regarding attitudes, higher monthly family income was associated with more positive attitudes, while larger family size was associated with lower positive attitudes. Women in husband-headed households had more positive attitudes than those in other-headed households, and women with previous CS had lower positive attitudes. Importantly, higher knowledge scores were strongly associated with more positive attitudes toward CS. Conclusion Strengthening antenatal care, including health, educational, and counselling services, particularly for rural women, larger families, husband-headed households, and women with prior CS, could improve knowledge and promote informed, positive attitudes toward appropriate CS use. Policies and programs should prioritize rural outreach, improve provider–patient communication (especially after a CS), and ensure high-quality counselling, informed consent, and male-inclusive antenatal sessions to support the appropriate use of CS.