Comparison of Indications for Cesarean Section in Zaria, Nigeria: 1985 and 1995

Background: Cesarean section (CS) rates and indications give a reflection of the maternal health status in the environment. This study was carried out to compare the CS rates and indications in this unit in 1985 and 1995, with a view to determining changes in the health seeking behaviour and possibly maternal health of women in Zaria and its environs.
Method: A retrospective review of the records of CS performed in 1985 and 1995.
Results: The cesarean section rates in this center in 1985 (9.21%) and 1995 (11.41%) are within the range reported previously. The CS rate was significantly higher in 1995 as compared to 1985 (p = 0.02). Cephalo-pelvic disproportion and its sequelae formed the majority of indications for CS unit in both 1985 and 1995 but the proportion constituted by this indication was significantly lower in 1995 (p = <0.001). Placenta praevia and breech presentation formed significantly greater proportions of the indications for CS in 1995 than in 1985 (p = 0.001 and <0.001, respectively).
Conclusion: These findings suggest some improvement in the maternal health among women that utilize the services of this hospital, which may be a reflection of the situation in the general population. The changes observed may also have resulted from improved diagnostic facilities, increased awareness and referral of problem cases, and the more liberal policy towards CS deliveries and the current trend away from difficult vaginal deliveries. There is a need to maintain and improve public enlightenment programs on issues affecting the health of mothers in this environment.