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Abstract
Rates of Cesarean section at a large urban 'teaching hospital were reviewed for the period 1968-1978. Changes in indications for primary Cesarean section were investigated, utilizing a 500 case sample from a delivery log book source. An overall 150% increase in the Cesarean section rate was noted, and it was chiefly due to a progressive increase in the rate of primary section. The private patient population was found to have higher and more rapidly increasing primary section rates than the ward population. For the years 1968-1978, a more rapid increase was noted in the proportion of primary Cesarean section performed for breech presentation and for prolonged rupture of membranes in the ward patient group. The indication of fetal distress accounted for a significantly greater proportion of primary Cesarean section during the years 1971 and 1972 compared to other years for the ward patient group. Cephalopelvic disproportion and labor abnormalities ac- counted for the largest proportion of Cesarean section in all years.