CONTRIBUTING FACTORS TOWARDS THE RAISING TREND OF CESAREAN DELIVERY. (REVIEW ARTICLE)

Abstract

Introduction: Cesarean section (CS), once reserved for medically indicated emergencies, has progressively become a procedure of choice in many parts of the world, pushing global rates well beyond the WHO-recommended ceiling of 10–15%. This study was conducted to identify the factors contributing to this rising trend, with particular focus on cesarean delivery on maternal request (CDMR) in the absence of medical indication, and to provide a base for future interventions aimed at curbing unnecessary CS rates. Methods: A systematic literature review was conducted using research and review articles retrieved from Google Scholar, PubMed, Sci-Hub, and Biomedical Corner. Relevant articles addressing CS as a mode of delivery were downloaded, appraised, and synthesized. Results: The reviewed literature confirmed a consistent global rise in CS rates, driven less by medical necessity and increasingly by maternal, professional, and health-system factors. Maternal-level drivers included fear of labor pain, concerns over pelvic damage and sexual function, perceived safety for the baby, social and family influence, and the perception of CS as a marker of modernity or affluence. Provider-level drivers included defensive practice against litigation and convenience, while system-level factors included financial incentives in private care and inadequate training in assisted vaginal delivery. Conclusion: The rising CS rate is largely attributable to addressable psychosocial, clinical, and systemic factors rather than medical need. Public awareness, adherence to WHO guidelines, and structured psychological counseling for women requesting CDMR may help reduce unnecessary cesarean sections and move national rates toward the WHO-recommended benchmark.

Keywords: Cesarean delivery on maternal request; Cesarean section; Maternal request; Review article; WHO recommended rate