Distribution of Cesarean Deliveries Across the Robson 10-Group Classification Categories at a Tertiary Care Center in Eastern India: A Cross-Sectional Study

Background and objective: Cesarean section rates have risen steadily worldwide, and the World Health Organization recommends the Robson 10-group classification system as the global standard for monitoring and comparing cesarean section rates.The objective was to describe the distribution of cesarean deliveries across the Robson groups at a tertiary care hospital in Jharkhand, India, over 12 months, and to identify the groups contributing most to the total.Group-specific cesarean section rates were not calculated, as only cesarean deliveries were included.Materials and methods: This prospective, hospital-based, cross-sectional study was conducted in the Department of Obstetrics and Gynecology, Bokaro General Hospital, Bokaro, Jharkhand, India, between April 2024 and March 2025.All 300 women delivered by cesarean section during the study period were included and assigned to Robson groups based on the available obstetric variables.Groups 2 and 4 were subdivided according to labor onset, and group 5 according to the number of previous cesarean sections.Because only women delivered by cesarean section were enrolled, the total number of women delivering in each Robson group was unavailable.The analysis therefore describes the distribution of cesarean deliveries across the Robson groups rather than group-specific cesarean section rates.Categorical variables were summarized using frequencies and percentages, without inferential statistical testing.Results: Of 550 women who delivered during the study period, 300 underwent cesarean section, giving an overall cesarean section rate of 54.5%.Group 5 (women with a previous cesarean section) was the largest contributor, accounting for 84 of 300 cesarean deliveries (28.0%), followed by group 2 (nulliparous women with a term singleton cephalic pregnancy who underwent induction of labor or cesarean section before labor) with 79 (26.3%), group 1 with 48 (16.0%), and group 10 with 35 (11.7%).Groups 3 and 4 accounted for 17 (5.7%)and 19 (6.3%) cesarean deliveries, respectively.Groups 6 to 9 together accounted for 18 (6.0%)cesarean deliveries.Group 2A, comprising nulliparous women undergoing induction of labor, was the largest subgroup, accounting for 23.7% of all cesarean deliveries.Most procedures were performed as emergencies (223/300; 74.3%).All group percentages represent proportions of cesarean deliveries, not cesarean section rates within individual groups.Conclusions: Groups 5 and 2 together accounted for 54.3% of all cesarean deliveries and were the largest numerical contributors at this center.These groups therefore represent important priorities for auditing cesarean section indications.However, their relative contributions do not establish that either group had an unusually high cesarean section rate.The overall rate of 54.5% warrants institutional review, with comparisons against population-level estimates interpreted in light of differences in case mix and referral patterns.Routine recording of the total number of women delivering in each Robson group is recommended to enable calculation of group-specific cesarean section rates and completion of the standard Robson report table.