Rising trend in cesarean sections: a retrospective study at tertiary care hospital in Jammu


  • Shazia Zargar Department of Obstetrics and Gynecology, SMGS Hospital, Jammu, Jammu and Kashmir, India
  • Nikita Gandotra Department of Obstetrics and Gynecology, SMGS Hospital, Jammu, Jammu and Kashmir, India




Cesarean, Deliveries, Indications


Background: The uncontrolled wave of cesarean rates has increased globally which has resulted in a significant amount of maternal mortality and morbidity. The present study aims to evaluate the trend in cesarean section rates in Jammu, India. 

Methods: The present retrospective study was carried out at the department of Obstetrics and Gynecology, SMGS Hospital, Jammu, India. We collected data based on total number of deliveries and cesarean sections performed at the hospital during (March2015-Feb2020) along with indications for CS.

Results: The percentage of cesarean sections has increased drastically from 39.4% during (2015-16) to 49.9% in (2019-20). The study shows that the most common indication for CS is post CS followed by NPOL, Fetal distress, breech, APH, CPD, PIH and others.

Conclusions: There is a growing concern among public and health care providers regarding the escalating and uncontrolled trend of cesarean sections which needs to be curtailed within optimal limits recommended by WHO.



Lomas J. Holding back the tide of caesarean section. BMJ 1988;297(6648):569-70.

Bottoms SF, Rosen MG, Sokol RG. The increase in the caesarean birth rate. N Engl J Med. 1980;302(10):559-63.

Shearer EC. Education of vaginal birth after caesarean section. Birth. 1982;9(1):31-4.

Mayor S. Caesarean section rate in England reaches 22%. BMJ. 2002;324:1118.

Guihard P, Blondel B, Trends in risk factor for caesarean sections in France between 1981 and 1995; lessons for reducing the rates in future. Br J Obstet and Gynaec. 2001;108(1):48-55.

Odlind V, Haglund B, Pakkanen M, Otturblad Olausson P. Deliveries, mothers and newborn infants in Sweden, 1973-2000.Trends in obstretics as reported to the Swedish Medical Birth Registar. Acta Obstet Gynaecol Scand. 2003;82(6):516-28.

Belizan JM, Althabe F, Barros FC, Showalter E, Castro A, Bastian H, et al. Rates and implications of caesarean sections in Latin America: ecological study. BMJ. 1999;319(7222):1397-1402.

Ghotbi F, Akbari Sene A, Azargashb E, Shiva F, Mohtadi M, Zadehmodares S, et al. Women's knowledge and attitude towards mode of delivery and frequency of cesarean section on mother's request in six public and private hospitals in Tehran, Iran, 2012. J Obstet Gynaecol Research. 2014;40(5):1257-66.

Mendoza-Sassi RA, Cesar JA, Silva PR, Denardin G, Rodrigues MM. Risk factors for cesarean section by category of health service. J Public Health. 2010;44(1):80-90.

Robson, Michel S. Can the high Caesarean section rates be reduced? Recent advance in Obstet and Gynaec. 2004;22:71-84.

Kambo I, Bedi N, Dhillon BS, Saxena NC. A critical appraisal of cesarean section rates at teaching hospitals in India. Int J Gynecol Obstet. 2002;79(2):151-8.

Sreevidya S, Sathiyasekaran BW. High caesarean rates in Madras (India): a population‐based cross sectional study. BJOG: An Int J Obstet Gynaecol. 2003;110(2):106-11.

International Institute for Population Sciences, Mumbai National Family Health Survey (NFHS-1) 1992-93.

International Institute for Population Sciences, Mumbai National Family Health Survey (NFHS-2) 1998-99.

International Institute for Population Sciences, Mumbai National Family Health Survey (NFHS-3) 2005-06.

International Institute for Population Sciences, Mumbai (2017) National Family Health Survey (NFHS-4) 2015-16 India Fact sheet.

Stanton C, Ronsmans C. Recommendations for routine reporting on indications for caesarean delivery in developing countries. Birth. 2008;35(3):204-11.

Torloni MR, Betran AP, Souza JP, Widmer M, Allen T, Gulmezoglu M, et al. Classifications for caesarean section: a systematic review. PLoS One. 2011;6(1):e1456.

Singh G, Gupta ED. Rising incidence of caesarean section in rural area in Haryana, India: a retrospective analysis. Internet J Gynecol Obstetr. 2013;17(2):1-5.

Cuningham FG, Leveno KJ, Bloome SL, Hauth JC, Gilstrap LC, Wenstrom KD. Preterm birth. In: Rouse D, Spong C, Rainey B, Wendel GD, eds. Williams Obstetrics. 22nd ed. New York: McGraw-Hill. 2005:865-6.

Lavender T, Hofmeyr GJ, Neilson JP, Kingdon C, Gyte GML. Caesarean section for non-medical reasons at term. Cochrane Database Syst Rev. 2006;3:CD004660.

McCourt C, Weaver J, Statham H, Beake S, Gamble J, Creedy DK. Elective cesarean section and decision making: a critical review of literature. Birth. 2007;34(1):65-79.

Mi J, Liu F. Rate of caesarean section is alarming in China. Lancet. 2014;383(9927):1463-4.

Dosa L. Caesarean section delivery and increasingly popular option. Bull World Health Organ. 2001;79:1173.

De Muylder X. Caesarean section in developing countries: Some considerations. Health Policy Plan. 1993;8:101-12

Qazi M, Saqib N Rising trend of caesarean section in a tertiary hospital over half decade: a retrospective study. Int J Repr, Contraception, Obstet and Gynec. 2018;7(10):4097-102

Barber EL, Lundsberg LS, Belanger K, Pettker CM, Funai EF, Illuzzi JL. Indications contributing to the increasing cesarean delivery rate. Obstet Gynecol. 2011;118(1):29-38.

Stasiełuk A, Langowicz I, Kosińska-Kaczyńska K, Pietrzak B, Wielgoś M. Is the epidemic of cesarean sections the result of more liberal indications? Gynecol Poland. 2012;83(8):604-8.

Kolås T, Hofoss D, Daltveit AK, Nilsen ST, Henriksen T, Häger R, et al. Indications for cesarean deliveries in Norway. Am J Obstet Gynecol. 2003;188(4):864-70.

Mackenzie IZ, Cooke I, Annan B. Indications for cesarean section in a consultant unit over the decades. J Obstet Gynecol. 2003;23(3):233-8.

Nazneen R, Begum RA, Sultana K. Rising Trend of Caesarean Section in a Tertiary Hospital Over a Decade. Journal of Bangladesh College of Physi and Surg. 2011;29(3):126-32.






Original Research Articles