Selma DAĞCI, Volkan KIZILAY, Melike PÜNDÜK YILMAZ, Çiğdem KILINÇ, İclal İlknur ÖZDEMİR, Sedat AKGÖL
Zeynep Kamil Medical Journal - 2026;57(4):204-209
Objective: This study aimed to examine temporal trends in vaginal and cesarean deliveries in public hospitals in Istanbul between 2020 and 2024, with a focus on primary and primiparous cesarean sections across maternal age groups. Material and Methods: This retrospective, descriptive, multicenter study included delivery records from six public maternity hospitals affiliated with the Ministry of Health in Istanbul, Türkiye. All live births at >=24 weeks of gestation with complete demographic and delivery data were analyzed. Primary cesarean was defined as the first cesarean delivery in a woman, and primiparous cesarean was defined as a cesarean delivery in a woman giving birth for the first time. Maternal age was categorized into four groups: 15-18, 19-35, 36-39, and >=40 years. Data were extracted from electronic medical records, cross-verified against official statistics, and analyzed using descriptive statistics, chi-square tests, and the Cochran-Armitage trend test. Results: A total of 78,998 deliveries were recorded, of which 40,427 (51.1%) were vaginal deliveries and 38,571 (48.9%) were cesarean sections. The annual cesarean rate increased from 45.8% in 2020 to 51.2% in 2023 before slightly declining to 50.9% in 2024 (p<0.0001). Primiparous cesareans accounted for 11.8% of births and showed a significant upward trend (p<0.001), while primary cesarean rates remained stable (13.1%, p=0.412). Most primary and primiparous cesareans occurred among women aged 19-35 years, with notable increases among adolescents. Conclusion: Cesarean rates in Istanbul's public hospitals remain far above the thresholds recommended by the World Health Organization, with high proportions of primary and primiparous procedures. Targeted strategies addressing high-risk subgroups, standardization of classification systems, and strengthening care through greater involvement of midwives are urgently needed to reduce unnecessary cesarean deliveries.
