frequency of, and indications for the first time c-section in zanjan, iran

background & aim : the causes of increased rate of cesarean section (c-section) are not completely known. the repeated c-sections are frequently reported in studies conducted in iran. this study aimed to determine the frequency of, and indications for the first time csection (fcs) in zanjan, iran in 2012-2013. methods & materials : a cross-sectional study was conducted and systematic random sampling was used to select medical records of delivered women. we provided a selfstructured short questionnaire. data were collected from the medical records and analyzed using independent sample t-test, and chi-square test. results : a total of 4563 women have been delivered during the period of the study from which 1928 cases (42.25%) underwent c-section. among women who had c-section, 1144 cases (59.3%) underwent first time c-section. the three most frequent indications for fcs were prolonged labor (35.2%), meconium staining (22.2%), and fetal distress (21.9%). conclusion : the frequency of fcs is high in zanjan, iran. adequate following of programs to diminish the percentage of first time c-section and increase the number of vaginal birth would significantly reduce the prevalence of c-sections.