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.