Assessing caesarean section trends in tertiary care using Robson’s ten group classification

Madhulika Sinha, Taruna Dua


Background: This study determined which clinical situations contributed to and led to caesarean delivery in tertiary care hospitals, using Robson’s classification approach, and to audit the rising prevalence of caesarean sections.

Methods: This retrospective data collection study was conducted for 2 years at a tertiary care hospital. Mothers who gave birth between October 2017 and 2019 were included in the study. Using Robson’s method they were categorized into ten groups. In each of the ten categories, the caesarean delivery rates were calculated and analysed. The contribution of each category to the overall caesarean section rate and percentage was computed.

Results: In our hospital, 384 of the 550 women who gave birth during the study period underwent a lower segment caesarean section (LSCS), with an overall C section rate of 69.8%. Group 5 (multiparous with prev 1 or more LSCS) contributed to the highest C-sections followed by group 2 (Primi who were induced or whose caesarean section was done without labour). Although groups 6, 7, 8, and 9 did not contribute significantly to overall C-sections, C section rates in this group of patients are approaching 100%. The primis who came in spontaneous labour had the least LSCS rate (29.47%).

Conclusions: Women who have had a previous caesarean delivery and primigravidas who were induced or had LSCS without labour account for a growing percentage of caesarean deliveries. Public policies and awareness should be aimed at minimising LSCS, especially by lowering the number of elective CS in these women and supporting vaginal delivery.


Caesarean section, Robson classification, Labour, Hospital

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