The changing incidence of caesarean section in the Health District of Central Manchester

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Abstract
The caesarean section rate in England and Wales has practically doubled from 5·6% in 1974 to 10·6% in 1982. Because most statistical reports are based on the practice of individual hospitals and do not reflect what is occurring in a particular community, a retrospective study of the incidence of, and reasons for, caesarean section performed in residents of the geographically defined Health District of Central Manchester was carried out for 1974 and 1982. The caesarean section rate in this community increased from 7% in 1974 to 16% in 1982. Caesarean sections performed for (i) failure to progress in labour, (ii) previous caesarean section and (iii) preterm fetal compromise before labour accounted for three quarters of the increase. Breech presentation was not a significant contributor to the increase. The reasons for the increase in caesarean sections performed for failure to progress in the first stage of labour were not clarified in the records, and is the subject of prospective investigation.

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