Protective care during pregnancy in Kathmandu

C-Section Rates in Kathmandu: Why Are They So High?

Soraya Malik in Health & Wellness December 2025 • 4 min read.

"A new study reveals alarmingly high cesarean section rates in Kathmandu, Nepal. What's driving this trend, and what can be done?"

Cesarean section rates (CSR) are a significant public health concern globally. Over the past few decades, there's been a notable increase in C-sections, raising questions about the factors contributing to this trend. A recent study conducted at Kathmandu Medical College in Nepal sheds light on the local landscape of C-section deliveries.

While increased access to gynecological and obstetrical care has improved institutional deliveries in many developing countries, the rate of cesarean sections in Nepal remains relatively low compared to some nations. However, hospital-based data suggests a rapid increase in C-section deliveries, particularly in certain regions.

This article delves into the findings of the Kathmandu Medical College study, examining the C-section rate and the primary reasons behind these surgical births in their specific setting. Understanding these factors is crucial for implementing targeted measures to address the rising CSR and mitigate potential associated problems.

Kathmandu's C-Section Profile: Key Findings

Protective care during pregnancy in Kathmandu

The study analyzed 1,172 deliveries at Kathmandu Medical College between June 2015 and January 2016. The overall cesarean section rate was a significant 45.81%. Here’s a breakdown of the key demographics and indications:

Demographics:

Age: Most patients were between 25-29 years old (42.8%).
Parity: A slight majority were first-time mothers (primigravida) at 51%.
Type: Emergency C-sections accounted for 76.5% of cases, while elective C-sections were 23.4%. Multigravida patients (those with previous pregnancies) underwent elective procedures more often than primigravida patients (73.8% vs 25.39%).

Leading indications for C-sections were:

Addressing High C-Section Rates: A Call to Action

The study's conclusion highlights a C-section rate significantly higher than the 10-15% recommended by the World Health Organization (WHO). The predominance of emergency C-sections, with previous cesarean births being a leading factor, warrants further investigation.

Several factors could contribute to this elevated rate. These include fear of litigation, increased use of electronic fetal monitoring (potentially leading to over-diagnosis of fetal distress), and a higher proportion of breech deliveries performed via C-section. Limited access to techniques like fetal scalp blood pH estimation (to confirm fetal distress) and external cephalic version (to turn breech babies) may also play a role.

Addressing the high C-section rate in Kathmandu requires a multi-pronged approach. This includes promoting vaginal birth after cesarean (VBAC) when appropriate, refining fetal monitoring practices, exploring strategies to reduce failed inductions, and ensuring access to techniques that can minimize the need for surgical deliveries. By understanding the specific drivers in the local context, healthcare providers and policymakers can work together to optimize maternal and neonatal outcomes.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.3126/jnhrc.v15i2.18165, Alternate LINK

Title: Profile Of Caesarean Section At Kathmandu Medical College

Subject: General Medicine

Journal: Journal of Nepal Health Research Council

Publisher: Nepal Health Research Council

Authors: Apurwa Prasad, Garima Bhandari, Rachana Saha

Published: 2017-09-15

Everything You Need To Know

What does the Cesarean section rate (CSR) represent, and what is its significance in this context?

The Cesarean section rate (CSR) refers to the percentage of deliveries performed via surgical incision through the abdomen and uterus. In the context of Kathmandu Medical College, a recent study found a CSR of 45.81%, which is notably higher than the 10-15% recommended by the World Health Organization (WHO). The implications of a high CSR include increased risks of complications for both the mother and the newborn, as well as higher healthcare costs.

What are the primary reasons contributing to the high C-section rates?

Several factors contribute to the rising C-section rates. The study at Kathmandu Medical College revealed that the leading indications for C-sections were previous cesarean births, fetal distress, and cephalopelvic disproportion. The prevalence of emergency C-sections, as opposed to elective ones, also indicates the urgency with which these procedures are being performed. Understanding these factors is crucial to developing targeted interventions to address the issue.

What is the difference between emergency and elective C-sections?

The difference between emergency and elective C-sections lies in the timing and circumstances of the procedure. Emergency C-sections are performed when there is an immediate threat to the health of the mother or the baby, often due to unexpected complications during labor, as observed at Kathmandu Medical College. Elective C-sections are scheduled in advance, usually for medical reasons that do not pose an immediate threat. The study found a significant disparity in the types of C-sections performed, with emergency procedures being far more common.

What were the key findings regarding the demographics of the patients in the study?

The study analyzed 1,172 deliveries at Kathmandu Medical College between June 2015 and January 2016. The key demographic findings included the age of the patients (mostly 25-29 years old) and their parity (the majority being first-time mothers or primigravida). Analyzing these demographic characteristics helps researchers understand the patterns and risk factors associated with C-section deliveries within this specific population.

Why are high C-section rates considered a public health concern?

High C-section rates are a significant public health concern because they can lead to various problems. Mothers face increased risks such as infection, excessive bleeding, and longer recovery times. Newborns may experience respiratory issues or other complications. The high CSR observed at Kathmandu Medical College indicates a need for strategies to address the issue, such as promoting vaginal birth whenever possible and addressing the factors that contribute to unnecessary C-sections.