Background

Cesarean section (CS) is one of the most commonly performed surgical procedures worldwide. While cesarean delivery can be life-saving for both mother and infant when medically indicated, rising cesarean section rates have become a major public health concern. Multiple maternal, fetal, healthcare system, and socioeconomic factors contribute to increasing cesarean delivery rates.

Objective

This study aimed to evaluate factors influencing cesarean section rates and identify demographic, obstetric, clinical, and institutional determinants associated with cesarean delivery.

Methods

A retrospective observational study was conducted involving 2,000 deliveries recorded across multiple healthcare facilities over a two-year period. Maternal demographic characteristics, obstetric history, fetal factors, clinical indications, and healthcare facility characteristics were analyzed. Multivariate logistic regression was used to identify independent predictors of cesarean delivery.

Results

The overall cesarean section rate was 36.8%. Previous cesarean delivery, maternal age above 35 years, fetal distress, labor induction, multiple pregnancies, obesity, and private healthcare facility delivery were significant predictors of cesarean section. Previous cesarean section demonstrated the strongest association with repeat cesarean delivery (OR = 5.4; 95% CI: 4.2–6.8).

Conclusion

Cesarean section rates are influenced by multiple clinical and non-clinical factors. Efforts to optimize labor management, encourage vaginal birth after cesarean (VBAC), and implement evidence-based obstetric practices may contribute to reducing unnecessary cesarean deliveries.