A survey on causes of cesarean sections performed at the university hospitals of Niknafs and Ali-Ibn Abi Talib of Rafsanjan, Iran, in the second trimester of 2014

Background: The increase in the prevalence of cesarean section (C-section) in recent decades has become a public health problem worldwide. Studies of cesarean section in order to identify the causes and form policies and interventions to reduce the incidence of this health problem are necessary. This study was conducted with the aim to investigate the causes of C-sections performed at Niknafs and Ali-Ibn Abi Talib Hospitals in Rafsanjan, Iran, in the second trimester of 2014. Materials and Methods: In this cross-sectional study, 560 pregnant women were selected from among those referred to Niknafs and Ali-Ibn Abi Talib Hospitals in the second trimester of 2014 for cesarean delivery. Information was collected using a researcher-made checklist through interviews with patients and reviewing medical records. Data were analyzed using chi-square or Fisherʹs exact tests, as required. Results: The mean and standard deviation of age of women was 29.46 ± 5.08 years and most of them (65.0%) were in the age range of 26-36 years and had a diploma (40.7%). Considering delivery history, the highest percentage of women had had a single delivery (38.9%) and over half of the subjects (52.9%) had experienced a previous C-section. The most common causes were repeated C-section (52.9%), elective C-section (on maternal request) (7.5%), meconial stained (6.1%), fetal distress (5.0%), and breech presentation (4.5%). Statistically significant associations were observed between C-section reasons, and age (P < 0.001), number of previous pregnancies (P < 0.001), and previous delivery method (P = 0.010). Conclusions: Repeated C-section, as the most common cause of cesarean, has had a major role in increasing cesarean. Vaginal delivery after cesarean, taking into account the clinical and legal circumstances and providing training programs to acquaint women to the negative consequences of C-section and vaginal delivery benefits would be effective in the choice of delivery and might help in reducing cesarean.