Comparison of Cesarean Causes before and after Implementation of Health Sector Evolution Plan in Kurdistan Province

Cesarean section (CS) is the most common surgical procedure in midwifery, performing of which in unnecessary cases can have adverse maternal and neonatal outcomes. The CS rate has risen over the past decades in the world. The Iranian Ministry of Health and Medical Education has implemented a health sector evolution plan in order to reduce the CS rate in Iran. This study aimed to compare the rate and the causes of CS before and after this plan in Kurdistan province, Iran.

This descriptive-analytical study was conducted on 400 medical files of women undergoing a cesarean section in public hospitals in Kurdistan province during 2013-2014. Subjects were selected by systematic sampling, and the number of samples from each city of Kurdistan province was determined based on the proportion of the number of deliveries in every city. Data were collected using structured checklists, and data analysis was performed in SPSS version 21.

In this study, CS rates decreased from 39.3% in 2013 to 34.3% in 2014 (after the implementation of the plan). The results were also indicative of no significant difference between 2013 and 2014 regarding the causes of CS. Moreover, the most common causes for CS were previous CS, fetal distress and lack of labor progression.

Implementation of the health sector evolution plan was effective in reducing the CS rate in Kurdistan province. Therefore, continuation and proper implementation of this program can prevent unnecessary CS.