That birth complications were significantly associated with unplanned cesarean sections is to be expected-given that complications such as fetal distress, preeclampsia, prolonged/obstructed labor, or shoulder dystocia are primary indications for cesarean section delivery [8, 24] . It is also not surprising that duration of labor is associated with unplanned cesarean section. We also observed that women who delivered vaginally in this sample had longer labors than those who had unplanned cesarean sections (data not shown). It was interesting to note that in this study the length of time women were allowed to attempt labor before a cesarean section was chosen was much shorter than in the United States (average unplanned cesarean section labor duration in this study was 3.5 hours, compared to 16.0 hours among nulliparas and 12.4 hours among multiparas in the United States [58] ).