Causes for the rise of cesarean section rate and its countermeasures

Objective: To study the causes for the increase of cesarean section rate(CSR) and the countermeasures.Methods: The number of gravitas delivered in our hospital during 1991-2004,the number of cesarean section and the number of forceps delivery and fetal aspiration were recorded.The change of CSR and the indication of cesarean section(CS) during the last 14 years were analyzed retrospectively.Results: The CSR increased year by year during the last 14 years.Dystocia(including uterine inertia,relative cephalopelvic disproportion,fetal macrosomia,persistent occiput posterior position and persistent occiput transverse position etc. were the first indication of CS, but fetal distress and social factors played an important role in the rise of CSR.The differences were significant(P<0.05-P<0.01).Meanwhile, the rate of obstetrical forceps and fetal aspiration decreased gradually.Conclusions: Fetal distress and social factors are the main causes for the rise of CSR.Correct diagnosis of fetal distress,proper management of dystocia,strict mastery of the indication of CS,psychological control and reliable delivery can help reduce the CSR.