ArticleBMJ open2021
Can the Robson 10 Group Classification System help identify which groups of women are driving the high caesarean section rate in major private hospitals in eastern Ethiopia? A cross-sectional study.
Article in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.
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5 citing papers in PubMed, 1 synthesis or guideline pooled it, 7 citations in OpenAlex.
- Primary cesarean section in Sub-Saharan Africa: A systematic review and meta-analysis using the Robson Ten-Group Classification System.PloS one · 2026Pooled it
- The role of context in strategic human resource management within private hospitals in Ethiopia, compared to public hospitals.Frontiers in health services · 2026Article
- A Retrospective Analysis of the Robson Classification Implementation in a Tertiary Care Hospital in Serbia.Journal of clinical medicine · 2025Article
- Cross-sectional analysis of caesarean sections according to the Robson 10-group classification system in Somalia.BMJ open · 2025Article
- Robson classification of caesarean births: implications for reducing caesarean section rate in a private tertiary hospital in Nigeria.BMC pregnancy and childbirth · 2023Article
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Authors and funding
4 authors at 3 institutions in 2 countries.
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Abstract
objectiveThe rates of caesarean section (CS) in Ethiopian private hospitals are high compared with those in public facilities, and there are limited descriptions of groups of women contributing to these high rates. The objective of this study was to describe the groups contributing to increased CS rates using the Robson classification in two major private hospitals in eastern Ethiopia.
designCross-sectional study.
settingTwo major private hospitals in eastern Ethiopia.
participantsAll women who gave birth from 9 January 2019 to 8 January 2020 in two major private hospitals in eastern Ethiopia. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome was the Robson 10 Group Classification System. The secondary outcome was indication for CS as recorded in the medical files.
resultsOf 1203 births in both hospitals combined during the study period, 415 (34.5%) were by CS. Women with a uterine scar due to previous CS (group 5), single cephalic term multiparous women in spontaneous labour (group 3) and single cephalic term nulliparous women in spontaneous labour (group 1) were the leading groups contributing 33%, 27.5% and 17.1%, respectively. The leading documented indications were fetal compromise (29.4%), previous CS (27.2%) and obstructed labour (12.3%).
conclusionMore than three-fourths of CS were performed among Robson groups 5, 3 and 1, indicating inadequate trial of labour after CS or management of labour among relatively low-risk groups (3 and 1). Improving management of spontaneous labour and strengthening clinical practice around safely providing the option of vaginal birth after CS practice are strategies required to reduce the high CS rates in these private facilities.
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