title: Epidemic of cesarean section at the general, private and university hospitals in Thailand.
abstract: OBJECTIVE
  To undertake a survey of cesarean section in the general, private and university hospitals in Thailand.
  
  
  METHODS
  Postal questionnaires were sent to all the general, private and university hospitals with 200 beds or more. The questionnaires were prepared to find out the percentage, the indications and the trend of cesarean delivery, the measures taken to decrease cesarean section rate, and the practice of external cephalic version (ECV) and vaginal birth after cesarean section (VBAC) in the hospitals.
  
  
  RESULTS
  The overall response rate was 88%. Mean cesarean section rates were 24, 48, and 22% in the general, private and university hospitals, respectively. Cesarean section rates in most of the hospitals were increased in the past 5 years namely 78% in the general hospitals, 50% in the private hospitals, 66% in the university hospitals. However, only 38% of the hospitals had measures to regulate this operation. Repeated cesarean section was the most common indication in the private (63%) and the university hospitals (88%) while failure to progress was the most common indication in the general hospitals (55%). ECV and VBAC were performed in 26 and 12% of the hospitals. They were, however, not the standard practices.
  
  
  CONCLUSIONS
  Rising of cesarean section rate without any measure to regulate it is the problem in the developing countries. Standardised labor management and reduction of unnecessary primary cesarean section will automatically reduce repeated operation and overall cesarean section.
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: B
authors.initials: B
authors.lastname: Chanrachakul
authors.forename: Y
authors.initials: Y
authors.lastname: Herabutya
authors.forename: U
authors.initials: U
authors.lastname: Udomsubpayakul
mesh_terms: D002585:Cesarean Section / Q000706:statistics & numerical data*; D005260:Female; D019538:Health Care Surveys; D006300:Health Services Misuse / Q000706:statistics & numerical data*; D006769:Hospitals, General / Q000706:statistics & numerical data*; D016304:Hospitals, Private / Q000706:statistics & numerical data*; D006785:Hospitals, University / Q000706:statistics & numerical data*; D006801:Humans; D011247:Pregnancy; D011795:Surveys and Questionnaires; D013785:Thailand / Q000453:epidemiology; D014600:Utilization Review