The Factors Influencing Cesarean - Section Rates - A Narrative Review from Pakistan

    Bakhtawar Khowaja(1*), Farida Bibi Mughal(2), Komal Valliani(3)


The significant increase in the rate of cesarean section is a major public health issue. The World Health Organization recommends C-section rates not to be greater than 10% and not lower than 5% as both the indicated limits can adversely affect maternal and newborn health. The rate of C-section deliveries is 22% according to recent Pakistan demographics and Health Survey of 2017-2018. This study contributes to the existing literature by examining the factors influencing high C-section rates in Pakistan. A narrative review of published literature between 2000 to 2020, on “factors influencing C-section rates in Pakistan” was done. The findings highlighted five factors that primarily influence utilization of C-section which include: 1. Accessibility to utilize C-section, 2. Association of C-section rates with socioeconomic profile, 3. Elective C-section, 4. Medical conditions as a cause of C-section, 5. C-section as a source of business. Pakistan like other Low middle income countries (LMICs) is facing the increased disease burden on its week and fragile health system. The over utilization of C-section rates has imposed additional burden on the health care system of Pakistan as well as increased economic and health resource liability on maternal care.

Keywords: C-section, public health, utilization of C-section, socioeconomic profile, source of business, medical conditions

(1) Aga Khan Univeristy
(2) School of Nursing and Midwifery, The Aga Khan University, Karachi.
(3) Digital Health Resource Centre, The Aga Khan University, Karachi.
(*) Corresponding Author
How to Cite
Khowaja, B., Mughal, F. B., & Valliani, K. (2021). The Factors Influencing Cesarean - Section Rates - A Narrative Review from Pakistan. Pakistan Journal of Medical Research, 60(3), 143-147. Retrieved from