Frequency of, and indications for the first time C-section in Zanjan, Iran

  • Elham Shakibazadeh Department of Midwifery, School of Nursing and Midwifery, Zanjan University of Medical Sciences, Zanjan, Iran.
  • Rana Bayat Department of Midwifery, School of Nursing and Midwifery AND Student Research Committee, Zanjan University of Medical Sciences, Zanjan, Iran.
  • Azam Tahernejad Department of Midwifery, School of Nursing and Midwifery AND Student Research Committee, Zanjan University of Medical Sciences, Zanjan, Iran.
  • Sonia Sepehri Department of Midwifery, School of Nursing and Midwifery AND Student Research Committee, Zanjan University of Medical Sciences, Zanjan, Iran.
Keywords: C-section, indication, first time Cesarean section, frequency


Background & Aim: The causes of increased rate of Cesarean section (C-section) are not completely known. The repeated C-sections are frequently reported in studies conducted in Iran. This study aimed to determine the frequency of, and indications for the first time Csection (FCS) in Zanjan, Iran in 2012-2013.Methods & Materials: A cross-sectional study was conducted and systematic random sampling was used to select medical records of delivered women. We provided a selfstructured short questionnaire. Data were collected from the medical records and analyzed using independent sample t-test, and Chi-square test.Results: A total of 4563 women have been delivered during the period of the study from which 1928 cases (42.25%) underwent C-section. Among women who had C-section, 1144 cases (59.3%) underwent first time C-section. The three most frequent indications for FCS were prolonged labor (35.2%), meconium staining (22.2%), and fetal distress (21.9%).Conclusion: The frequency of FCS is high in Zanjan, Iran. Adequate following of programs to diminish the percentage of first time C-section and increase the number of vaginal birth would significantly reduce the prevalence of C-sections.


Belizán JM, Althabe F, Barros FC, Alexander S. Rates and implications of cesarean section in latin America. BMJ. 1999; 319(7222): 1397– 1402.

Jamshidimanesh L, Jouybary F. The Process of Womens Decision Making for Selection of Cesarean Delivery. Iran J Nurs. 2009;21(56): 55-67.

World Health Organization. World Health Statistics. Geneva: WHO; 2009.

Ahmadnia SDB, Einizinab H, Kazemipour S, Mehryar AH, M. N. Caesarean section in the Islamic Republic of Iran: prevalence and some sociodemographic correlates. Eastern Mediterranean Health Journal. 2009;15(6): 1389-98.

Taffel SM, Placek PJ, Moien M, Kosary CL. 1989 US Cesarean section rate studies. VBAC rises to a nearly one in five. Birth. 1991;18(2): 73-7.

MacDorman MF, Menacker F, Declercq E. Cesarean Birth in the United States: Epidemiology, Trends, and Outcomes. Clinics in Perinatology 2008;35(2): 293–307.

National Institutes of Health. State of the Science Conference Statement. Cesarean delivery on maternal request March 27-29, 2006. Obstetrics and Gyneacology. 2006;107: 1386-97.

Zupancic J. The economics of elective Cesarean section. Clinical Perinatology. 2008; 35: 591-9.

Lui T, Chen C, Lin H. Does elective Cesarean section increase utilization of postpartum maternal medical care? Medical Care. 2008;46(4):440-43.

Declercq E, Barger M, Cabral HJ, Evans SR, Kotelchuck M, Simon C, et al. Maternal outcomes associated with planned primary Cesarean section births compared with planned vaginal births. Obstetrics and Gynecology. 2007;109(3):669-77.

MacDorman MF, Declercq E, Menacker F, Malloy MH. Neonatal mortality for primary cesarean and vaginal births to low-risk women: application of an "intention to treat" model. Birth. 2008;35(1):3-8.

Vangen SC, Skrondal A, Magnus P. Cesarean section among immigrants in Norway. Acta Obster Gynecol Scand. 2000;79: 553-58.

Decherney AH, Nathan L, Goodwin TM, Laufer N. Current obstetric and gynecologic diagnosis and treatment. Lange Medical Books; 2012. P. 703-9.

Mohammadbeigi A, Tabatabaee HR, Salehi M, Yazdani N. Factors Influencing Cesarean Delivery Method in Shiraz Hospital. Iran Journal of Nursing. 2009;21(56):37-45.

Jamshidi Evanaki F, Khakbazan Z, Babaei G, Seyed Noori T. Reasons of choosing cesarean section as the delivery method by the pregnant women referred to healthtreatment centers in Rasht. Nurs School Tehran Univ Med Sci. 2004;10(22):51-60.

Yvangi M, Sohrabi MR, Alishahi Tabriz A. Effect of Iranian Ministry of Health Protocols on Cesarean Section Rate: A Quasi- Experimental Study. Journal of Research in Health Sciences. 2013; 13(1): 48-52.

Belizan JM, Althabe F, Cafferata ML. Health consequences of the increasing caesarean section rates. Epidemiology 2007,18 (4):485– 6.

Yazdizadeh B, Nedjat S, Mohammad K, Rashidian A, Changizi N, Majdzadeh R. Cesarean section rate in Iran, multidimensional approaches for behavioral change of providers: a qualitative study. BMC Health Services Research 2011;11: 159-172.

Shariat M, Majlesi F, Azari S, Mahmoudi M. Cesarean section in maternity hospitals in Tehran, Iran. Payesh, J the Iranian Institute for Health Sciences Research. 2002;1(3):5-10.

Shakeri M, Mazloomzadeh S, Mohammadian F. Factors affecting the rate of Cesarean section in Zanjan maternity hospital in 2008. Journal of Zanjan University of Medical Sciences. 2012; 20(80): 91-104.

Kashanizadeh N. Frequency and causes of sesarean section in baghiat allah hospital in 1999. Kosar Medical Journal. 2002;7(3):239- 43.

Delaram M, Safdari F, Forouzandeh N, Kazaemian A. Frequency and maternal and fetal indications of the first time Cesarean Section, chaharmahal va bakhtiyari, 1997. J shahre kord Univ Med Sci. 1999;1(53):44-9.

Maaløe N, Sorensen B, Onesmo R, Secher N, Bygbjerg I. Prolonged labor as indication for emergency caesarean section: a quality assurance analysis by criterion-based audit at two Tanzanian rural hospitals. BJOG: An International Journal of Obstetrics & Gynaecology 2012; 119: 605–613. doi: 10.1111/j.1471-0528.2012.03284.x

Sasikala A, Raghavan S, Mishra N, Khatoon S, Bupathy A, Rani R. Perinatal outcome in relation to mode of delivery in meconium stained amniotic fluid. Indian J Pediatr 1995 Jan-Feb;62(1):63-7.

Choudhary D, Bano I, Ali SM. Does amnioinfusion reduce caesarean section rate in meconium-stained amniotic fluid. Arch Gynecol Obstet 2010;282(1):17-22. doi: 10.1007/s00404-009-1196-8.

Gaffney G, Sellers S, Flavell V, Squier M, Johnson A. A case­control study of intrapartum care, cerebral palsy, and perinatal death. BMJ 1994;308:743­50.

James D. Caesarean section for fetal distress. The 30 minute yardstick is in danger of becoming a rod for our backs. BMJ 2001;322:1316–7.

Kolas T, Hofoss D, Daltveit AK, Nilsen ST, Henriksen T, Hager R, et al. Indications for cesarean deliveries in Norway. American Journal of Obstetrics and Gynecology 2003; 188 (4): 864–870.

Menacker F, Hamilton BE. Recent trens in Cesarean delivery in the United States. DHHS Publication No. 35; 2010.

Tollånes MC. Increased rate of Caesarean sections- causes and consequences. Tidsskr Nor Laegeforen. 2009 Jun 25;129(13):1329-31. doi: 10.4045/tidsskr.08.0453. [Article in Norwegian]

Shakeri M, Shakibazadeh E, Arami R, Soleimani M. Cesarean Delivery on Maternal Request in Zanjan, Iran. Life Science Journal 2013;10(1)

How to Cite
Shakibazadeh E, Bayat R, Tahernejad A, Sepehri S. Frequency of, and indications for the first time C-section in Zanjan, Iran. NPT. 1(4):207-12.
Original Article(s)