Background: Numerous studies show a growing trend in cesarean section rates throughout the world, including Iran. However, existing evidence in our country is scant and previous reports are restricted to short time periods. The aim of the current study is to measure the trend in cesarean sections (CS) rates over the past 30 years in a referral hospital in Tehran. Methods: We routinely collected data on the demographic characteristics of all women who gave birth in the hospital during the study period. The mode of delivery and the personnel in charge of delivery has like wise been recorded for each birth during the study period. The data were extracted from medical records and entered into a structured checklist. Results: The rate of CS out of all deliveries increased from 14.3% in 1979 to 22.7% in 1989, 52.5% in 1999, and 85.3% in 2009 (P < 0.001). The most common reason for CS was a repeated section. The percentage of vaginal deliveries performed by midwives has not changed significantly and the number of both midwives and obstetricians per 1000 births has increased, from 2.8 to 15.4 midwives per 1000 births and from 5.5 to 23.0 obstetricians per 1000 births. Conclusion: Immediate strategies should be adopted to prevent the rising trend and increasing number of unnecessary CS in Iran.
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