The Rate of Cesarean Section and Its Indications Before and After the Implementation of Health System Reform in the Hospitals of Mazandaran Province, 2013-2016

Background and purpose: Increase in cesarean section (C-Section) is a health system problem around the world. The aim of this study was to compare the rate of C-Section and indications for that before and after implementation of Health System Reform in the hospitals of Mazandaran province, Iran. Materials and methods: This descriptive cross-sectional study was conducted analytically. The indications for C-Section were recorded based on curative treatment checklist before implementation of the Health System Reform (2013) and after that (2016). Data were analyzed in SPSS V21 applying t-test and Chi-square. Results: The rate of C-Section was significantly lower only in governmental hospitals after implementation of the Health System Reform (P< 0.05). Among the indications of C-Section, only the previous C-Section had a significant difference before and after the Health System Reform in total hospitals in the province (P