Caesarean section rates and indications: a cross-sectional study from a tertiary care centre in Türkiye

Globally, including in Türkiye, caesarean section (C-section) rates have been rising steadily, largely due to changes in clinical practices, maternal preferences, medico-legal concerns, and healthcare system dynamics. This study aims to investigate the impact of a high patient load on C-section rates and their indications within a tertiary care setting.

This retrospective study was conducted on women with deliveries over four years, from June 1, 2020, to May 1, 2025. For pairwise comparisons, numerical and nominal variables were analysed with independent t-test or Pearson's chi-squared test, respectively. A p-value < 0.05 was accepted as statistically significant. All variables were expressed with 95% confidence intervals (CI).

A total of 68,944 deliveries were eligible for analysis, with an overall C-section rate of 55.0%. Among the indications C-section, the most common was previous uterine surgery, including prior C-section and/or myomectomy, accounting for 56.2% of cases. This was followed by foetal distress (24.3%). Other foetal-related indications included multiple gestation (6.2%), foetal malpresentation (4.2%), and macrosomia (1.9%).Compared with women who had a normal vaginal delivery (NVD), those undergoing C-section had significantly higher percentage of male neonates, maternal age >35 years, multiparity, all categories of preterm birth, early-term birth, low birth weight, and macrosomia.

Our findings indicate that the overall C-section rate was 55.0%. Among the indications for C-section, the most common was previous uterine surgery, which includes prior C-section and/or myomectomy, followed by foetal distress.