Recommendations for routine reporting on indications for cesarean delivery in developing countries

Cynthia Stanton, Carine Ronsmans, Patricia Bailey, Jose Belizán, Pierre Buekens, Qian Chen, Cheikh T. Cisse, Andrea A. Creanga, Luc De Bernis, Dominique Dubourg, El Marie Farrell, Sara A. Holtz, Theo Lippeveld, Allisyn Moran, Dorothy Shaw, Tran Son Thach, Jane Thomas, Linda L. Wright

Research output: Contribution to journalArticlepeer-review

45 Scopus citations


Background: Cesarean delivery rates are increasing rapidly in many developing countries, particularly among wealthy women. Poor women have lower rates, often so low that they do not reach the minimum rate of 1 percent. Little data are available on clinical indications for cesarean section, information that could assist in understanding why cesarean delivery rates have changed. This paper presents recommendations for routine reporting on indications for cesarean delivery in developing countries. These recommendations resulted from an international consultation of researchers held in February 2006 to promote the collection of comparable data to understand change in, or composition of, the cesarean delivery rate in developing countries. Methods: Data are presented from selected countries, categorizing cesareans by three classification systems. Results: A single classification system was recommended for use in both high and low cesarean delivery rate settings, given that underuse and overuse of cesarean section are evident within many populations. The group recommended a hierarchical categorization, prioritizing cesareans performed for absolute maternal indications. Categorization among the remaining nonabsolute indications is based on the primary indication for the procedure and include maternal and fetal indications and psychosocial indications, required for high cesarean delivery rate settings. Conclusions: Data on indications for cesarean sections are available everywhere the procedure is performed. All that is required is compilation and review at facility and at higher levels. Advocacy within ministries of health and medical professional organizations is required to advance these recommendations since researchers have inadequately communicated the health effects of both underuse and overuse of cesarean delivery.

Original languageEnglish (US)
Pages (from-to)204-211
Number of pages8
Issue number3
StatePublished - Sep 2008


  • Cesarean
  • Classification
  • Routine health information system

ASJC Scopus subject areas

  • Obstetrics and Gynecology


Dive into the research topics of 'Recommendations for routine reporting on indications for cesarean delivery in developing countries'. Together they form a unique fingerprint.

Cite this