Analysis of caesarean section rates according to the Robson classification system and indications for caesarean delivery: experience from a tertiary health centre in Turkey

Background Globally and in Turkey, caesarean section (CS) rates have risen steadily over recent decades, reflecting changes in clinical practice, maternal preference, medico-legal concerns, and healthcare system dynamics. The Robson Ten-Group Classification System, complemented by analysis of CS indications, provides a standardised and objective framework for identifying modifiable factors contributing to the increasing use of CS. This study aimed to evaluate CS rates in a tertiary healthcare centre in Turkey using the Robson classification in conjunction with specific clinical indications. Methods This retrospective observational study included all women who delivered at Umraniye Training and Research Hospital, Department of Obstetrics and Gynaecology, between 01 August 2018 and 11 September 2025. Data were obtained from the hospital’s electronic birth registry and categorised according to the Robson Ten-Group Classification System and indications for CS. Results During the study period, 25,767 births were recorded, of which 11,939 (46.4%) were delivered by CS. The most significant contribution to the overall CS rate originated from Robson Group 5 (23.8%), followed by Group 1 (5.2%). The most common indication for CS was previous uterine surgery, including prior CS and/or myomectomy (54.9%), followed by foetal distress (19.1%). Conclusion The overall CS rate in this study was 46.4%, with Robson Groups 5 and 1 accounting for the majority of procedures (29.0% combined). Previous uterine surgery and foetal distress were the predominant indications.