A Retrospective Evaluation of Cesaerean Section Rates Performed Between 2009-2012 in Our Clinic: Can the Increase in C-Section Rates be Overcome?

Objective: The purpose of this study is to investigate the rates of vaginal and Cesarean delivery, to evaluate the indications of Cesarean sections and to see how our rates parallel with the ever increasing percentages of Cesarean sections performed in Turkey. In doing so we aim to find a feasible solution to lower this increase in Cesarean rates. Methods: Patients that were delivered at Elazig Research and Training Hospital Gynecology and Obstetrics Department between 01.01.2009 and 31.12.2012 were included. The patients' demographic features, their gravida and parity, mode of delivery, indications of Cesarean sections, the newborns' birth weights and genders were reviewed retrospectively. The rates and the indications of Cesarean sections were evaluated according to year of delivery. Results: Out of the 13874 deliveries that took place during years 2009 and 2012, the rate of normal spontaneous vaginal birth and cesarean section was 55.6% (n=7720) and 44.4% (n=6154) respectively. When the indications for Cesarean sections were taken into account, it was seen that 2391 (17.2%) of these patients were operated due to a previous Cesarean, 387 (2.7%) were due to breech presentation, 1067 (7.6%) due to cephalopelvic disproportion, 1125 (8.1%) due to fetal distress, 279 (2%) due to macrosomia and remaining patients underwent a Cesarean section for other reasons (abruptio placentae, prolapsed cord, multiple pregnancy, preeclampsia). By analyzing annual Cesarean statistics we determined that 41.6% (n=1491) of patients were delivered by cesarean section in 2009, 45.7% in 2010, 43% (n=1499) in 2011, and 43.7 (n=1225) in 2012. Conclusion: The increase in Cesarean section rates both in Turkey and worldwide are compatible. Strategies that require a multidisciplinary approach collaborating doctors, patients and health policy authorities have to be implemented immediately in order to decrease the Cesarean rates in Turkey