Escalating Caesarean Births in a Tertiary Care Centre in India: Trends and Predictors
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Abstract
Background: Global trends in cesarean section (CS) have been rising consistently. In India, the rates in tertiary hospitals are particularly high due to referral of complex cases. Trends over time and clinical indications need to be reviewed in order to inform practice and policy-making. Aim and objective: To evaluate trends and predictors of cesarean section deliveries between January 2020 and July 2025, with specific reference to the research question: “How have the rates and indications of cesarean section changed during this period, and what is their correlation with maternal and neonatal outcomes?” Methods: A retrospective observational study was conducted using institutional delivery records. Monthly and yearly data were extracted with regard to total deliveries, cesarean sections, indications for cesarean sections, and maternal demographics as well as neonatal and maternal outcomes. Statistical analysis and graphical presentation were performed using R Studio. Trend assessment and analyses of proportions were done using chi-square tests. Results: Of 15,346 deliveries, 9,430 (61.45%) were CS. The highest CS rate was in 2020 (71.54%) with a subsequent plateau at 59–61%. Leading indications were Cephalopelvic Disproportion (16.46%) and Previous CS with Mobile Head (12.98%), both with significant rising trends. Neonatal outcomes were excellent with NICU admissions at 16.92% and infant mortality at only 0.12%. Severe maternal complications were uncommon. Conclusion: This elevated CS rate is indicative of sophisticated case management and changing obstetric practice. VBAC promotion, AI surveillance, and systematic audit strategies are advocated to maximize the use of cesareans, enhance outcomes, and meet international standards.
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Copyright (c) 2025 Gomathi Meignanamoorthy, Jothikala Chellamuthu, Preethi Vasanth Kumar, Swathi N, Jamila Hameed
This work is licensed under a Creative Commons Attribution 4.0 International License.
Creative Commons License All articles published in Annals of Medicine and Medical Sciences are licensed under a Creative Commons Attribution 4.0 International License.
Gomathi Meignanamoorthy, Department of Obstetrics and Gynecology, District Headquarters Hospital, Pollachi, Tamil Nadu, India.
Department of Obstetrics and Gynecology, District Headquarters Hospital, Pollachi, Tamil Nadu, India.
Jothikala Chellamuthu, Department of Obstetrics and Gynecology, District Headquarters Hospital, Pollachi, Tamil Nadu, India.
Department of Obstetrics and Gynecology, District Headquarters Hospital, Pollachi, Tamil Nadu, India.
Preethi Vasanth Kumar, Department of Obstetrics and Gynecology, District Headquarters Hospital, Pollachi, Tamil Nadu, India.
Department of Obstetrics and Gynecology, District Headquarters Hospital, Pollachi, Tamil Nadu, India.
Swathi N, Statistician, Department of Medical Research, Karuna Medical College, Vilayodi, Chittur, Palakkad, Kerala, India.
Statistician, Department of Medical Research, Karuna Medical College, Vilayodi, Chittur, Palakkad, Kerala, India.
Jamila Hameed, Department of Obstetrics and Gynecology, Karuna Medical College, Vilayodi, Chittur, Palakkad, Kerala, India.
Department of Obstetrics and Gynecology, Karuna Medical College, Vilayodi, Chittur, Palakkad, Kerala, India.
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