Caesarean section rates analysed using Robson's 10-Group Classification System: a cross-sectional study at a tertiary hospital in Ethiopia.

Objective The aim of this study was to assess the caesarean section (CS) rates using Robson’s 10-Group Classification System among women who gave birth at Hawassa University Referral Hospital in southern Ethiopia. Design Cross-sectional study design to determine CS rate using Robson’s 10-Group Classification System. Setting Hawassa University Referral Hospital in south Ethiopia. Participants 4004 women who gave birth in Hawassa University Referral Hospital from June 2018 to June 2019. Results The 4004 women gave birth to 4165 babies. The overall CS rate was 32.8% (95% CI: 31.4%–34.3%). The major contributors to the overall CS rates were: Robson group 1 (nulliparous women with singleton pregnancy at term in spontaneous labour) 22.9%; group 5 (multiparous women with at least one previous CS) 21.4% and group 3 (multiparous women without previous CS, with singleton pregnancy in spontaneous labour) 17.3%. The most commonly reported indications for CS were ‘fetal compromise’ (35.3%) followed by previous CS (20.3%) and obstructed labour (10.7%). Conclusion A high proportion of women giving birth at this hospital were given a CS, and many of them were in a low-risk group. Few had trial of labour. More active use of partogram, improving fetal heartbeat-monitoring system, implementing midwife-led care, involving a companion during labour and auditing the appropriateness of CS indications may help to reduce the CS rate.