A retrospective analysis of cesarean section rate trends and indications using the Robson classification: A single-year hospital audit (2025)

Background/Objective: This study aims to evaluate the trends and underlying reasons for C-sections at GGH Kakinada during the calendar year 2025.Methods: This is a retrospective, quantitative analysis of existing hospital audit data from a single large healthcare facility, GGH Kakinada. Data were collected from routine monthly audit reports for the period January to December 2025. Descriptive statistics were used to summarize trends and identify frequent indications. The Robson Classification system was applied to determine the contribution of each group to the overall rate.Results: A total of 5,801 deliveries occurred, with an annual total of 2,778 LSCS, resulting in an annual C-section rate of 47.88%. This rate is substantially higher than the 10-15% optimal range suggested by the WHO. The top three contributing groups were Group 1, Group 5, and Group 2. The most common indications included fetal distress (27-36% of cases), previous C-section, cephalopelvic disproportion, pre-eclampsia, and failed induction.Conclusion: The high C-section rate at this facility highlights the need for targeted interventions. Identifying the primary contributors (Groups 1, 2, and 5) allows for specific strategies aimed at optimizing C-section rates in line with best practices.