KUMJ | VOL. 24 | NO. 3 | ISSUE 96 | JULY-SEPTEMBER, 2026

Analysis of Cesarean Sections Births using Robson’s Ten Group Classification System in the Tertiary Hospital of Nepal
Shakya S, Uprety S

Abstract:
Background Cesarean sections are life-saving in high-risk pregnancies, however its use has markedly increased in low- and middle-income countries. In Nepal, cesarean section rates rose three-fold from 1996 to 2016. The World Health Organization recommends regular auditing of cesarean section practices using Robson’s “Ten Group Classification System”. Objective To describe the obstetric population served by the maternity unit of Dhulikhel Hospital from 2019 to 2021, determine cesarean section rates using Robson’s “Ten Group Classification System” and assess neonatal outcome. Method A retrospective cross-sectional study was conducted at the Department of Obstetrics and Gynaecology, Dhulikhel Hospital, using secondary data from 2019 to 2021. Women with complete maternity records, 8398 women, were analyzed and classified according to Robson’s Ten Group Classification System. Descriptive statistics were used to calculate cesarean section rates, group sizes and each group’s contributions to the overall cesarean section rates. Result The overall cesarean section rate was 37%, increasing from 2019 to 2021. The mean maternal age was 25.7 ± 4.7 years, most women (54%) were nulliparous and 11.4% had history of at least one previous cesarean section. Group 5 (multiparous, previous cesarean section, term, cephalic) was the largest contributor to the overall cesarean section rate (26%), followed by Group 1 (22%) and Group 2 (18%). Conclusion The Robson Ten Group Classification System provides a standardized framework to accurately monitor cesarean section rates and identify priority groups. Its routine implementation can support evidence-based strategies to optimize cesarean delivery practices in Nepal.
Keyword : Cesarean section, Childbirth, High-risk pregnancy, Maternal age, Robson classification