THE C-SECTION SURGE: A STRUCTURED LITERATURE REVIEW OF GLOBAL TRENDS AND LOCAL PERCEPTIONS IN PAKISTAN

Abstract

Significant public health concerns have been raised by the global increase in Caesarean section (C-section) deliveries since the 1990s, especially in Pakistan, where rates have risen to over 22%. Although surgical intervention is primarily motivated by medical necessity, there is an increasing need to comprehend how maternal attitudes and socioeconomic factors impact these trends. The purpose of this study was to evaluate C-section delivery trends and look into women's attitudes, views, and level of knowledge about the technique. A descriptive study of women visiting Railway Hospital's outpatient department in Rawalpindi was carried out in conjunction with a systematic evaluation of the literature. Data were examined across various age groups to discern evolving views on safety and autonomy. The findings revealed that almost half of the participants fell within the 30–39 age range, with perceptions of safety differing markedly by age; 75% of younger women (20–29 years) considered C-sections to be unsafe, whereas acceptance rose among women aged over 40. Importantly, 78% of participants indicated that their physician was the main factor influencing their choice of delivery method, while merely 14% of decisions were made independently. Although 42% of women chose C-sections solely when medically necessary, previous birth experiences affected the decision for 25% of the group. These results imply that within the population studied, trends regarding C-sections are largely guided by physicians rather than maternal elective choices. Therefore, public health initiatives should prioritize clinical audits at the provider level and improve maternal education to ensure that delivery practices are consistent with medical requirements.