Rising Caesarean Section Rates: An Audit of Caesarean Sections in a Specialist Private Practice

Abstract

Background: Caesarean section (C/S) rates are increasing world wide; rates in the private sector in South Africa are reported to be particularly high. To the best of our knowledge, there has not been a recent audit of caesarean sections from the private health sector in KwaZulu-Natal. The aim of this study was to carry out an audit of C/S in a private practice. Methods: An audit of the patient records over a period of one year was done. No personal identifiers were noted or reported on. All relevant clinical data was pooled and used to analyse clinical information. Results: There were 364 deliveries in the study period and 209 of these were C/S, giving a rate of 60.4%. The majority of the C/S were done for a previous C/S; maternal request and HIV status also contributed to the high rate. Conclusion: The high C/S rate in private practice is probably a window of the increased caesarean section rates world wide. This high rate is in keeping with trends in countries such as South America, and is much, much higher than the ideal rate in low-risk obstetric populations of 10.15% suggested by the WHO.