Prevalence and associated factors of obstructed labor among mothers delivered at a tertiary care hospital in Uganda: A descriptive retrospective cross-sectional study.

Background: Obstructed labor (OL) is a major contributor to the high maternal and neonatal morbidity and mortality rates, especially in low and middle-income countries (LMICs) where structural barriers to accessing quality obstetric services are commonplace. This study aimed to document the magnitude of obstructed labor and its associated factors at a public regional referral hospital in Uganda.  Methods: A descriptive retrospective cross-sectional study was conducted at Kayunga Regional Referral Hospital in Uganda that involved a review of 2,176 hospital records of mothers who delivered from 1st January to 31st December 2023. A pretested data extraction tool was used for data collection from the patient charts. A Multivariate Modified Poisson Regression model was employed to identify determinants of obstructed labor.  Results: This study's prevalence of obstructed labor was 18.57% (405 out of 2176). Women referred from lower health facilities were likelier to experience OL, with a prevalence ratio of 1.83 (95% 1.43-2.34, p-value <0.001). Primipara mothers were 3 times more likely to encounter obstructed labor when compared to multigravidas (95% 1.94-6.35, p-value <0.001). Women of >42 weeks of gestation were 7 times more likely to encounter obstructed labor compared to those with 37-42 weeks (95% CI: 5.69-10.89, <0.001). The likelihood of encountering obstructed labor among mothers where a partograph was not used during labor was 3.55 times higher (95% CI: 2.68-4.70, p-value = <0.001) compared to those where a partograph was completed.  Conclusion: The prevalence of obstructed labor is still high in LMICs. Referral from a lower health facility, parity, and partograph utilization were significantly associated with obstructed labor.  Recommendation: Therefore, improving partograph use, training and equipping healthcare workers to diagnose OL, as well as early and timely interventions to prevent complications of OL, are recommended.