An audit of caesarean section in a maternity district.

A prospective study of the clinical indications for caesarean sections performed in a large specialist maternity hospital was carried out during the first 3 months of 1981; similar information was collected retrospectively for 1976 and 1971. Demographic changes in the obstetric population were considered. The district section rate increased from 4.4-13% in the last decade. The three most important clinical indications contributing to the rise of caesarean section in primiparae were cephalopelvic disproportion, slow progress and breech presentation. The rate of sections began to fall during the audit and has continued to decrease in the months since. Although it is rather early to draw conclusions, this trend may reflect the critical attention focused on section policy during the period of the study.