Trends in indications for caesarean sections over 7 years in a Welsh district general hospital.

The National Sentinel Caesarean Section (CS) Audit showed that the overall CS rate was 21.5% in England and Wales. There have been concerns about the rising CS rate in the UK. We reviewed whether there were any changes in indications for CS over 7 years (2001-2007) in our district general hospital. A database was written and used to record data about each CS, electronically. A library of entries was used to record the indications for all caesarean sections. The data were analysed by each of the years from 2001 to 2007. The overall CS rate in the hospital was nearly 30% in 2007, a rise from 26% in 2001. The commonest indication was previous single CS, followed by other indications: failure-to-progress during the first stage of labour, fetal distress and breech presentation. Over the 7-year period, we have been unable to show any real change in the proportions of indications for CS. Despite heightened awareness and regular feedback, there has been no detectable reduction in CS rates. They appear instead to have increased with no change in the proportions of indications.