Background

The escalating global rates of cesarean sections (C-sections) have raised concerns, with the World Health Organization recommending a rate of 10-15%. This study investigates the cesarean section rate, trends, indications, and potential causes at a tertiary medical center in Monrovia, Liberia.

Objectives

To determine the cesarean section rate, identify com­mon indications, analyze trends, and explore factors contributing to the high rate.

Materials and Methods

A retrospective review of cesarean deliveries and oth­er deliveries at John F. Kennedy Maternity Hospital, Liberia from January 2020 to December 2022 was con­ducted. Data on patient demographics, parity, booking status, and indications for C-section were collected and analyzed.

Results

The cesarean section rate averaged 46% over the study period, with a slight decrease from 47% in 2020 to 45% in 2021, followed by a rise to 48% in 2022. The leading indication for C-section was cephalopelvic disproportion (CPD), followed by previous cesarean section and fetal distress. A majority of the patients were between 21-35 years old, and most deliveries occurred at term.

Conclusion

The high cesarean section rate at John F. Kennedy Maternity Hospital exceeds WHO recommendations and warrants attention. Possible contributing factors include referral patterns, fear of litigation, and increas­ing maternal risk factors. Strategies to address this trend should focus on active labor management, re­ducing high-risk pregnancies, and refining indications for C-section.