Background: Even though the caesarean section is an essential component of comprehensive obstetric and new born care for reducing maternal and neonatal mortality. But this increasing trend of Caesarean section has not always resulted to a guaranteed quality improvement in perinatal outcome.

Objective: The aim of this study is to estimate and compare rates of delivery modes, indications and outcomes of caesarean section.

Method: A retrospective record based observational study of last 7 years (January 2013 to December 2020) in our institute, College of Medicine and JNM Hospital.

Results: The caesarean section rate increased 16.74% in last 7 years. Age of the mother, parity, previous caesarean and delayed referral were some of the important determinants of caesarean section rates. The most common indications of caesarean section were previous caesarean section (22.36%), PIH (14.38%), foetal distress (12.75%), breech (8.22%) and prolonged labour (3.0%)

 Conclusion: Encouraging vaginal delivery improves foetal and maternal health and changes the existing beliefs and attitude towards safe mode of delivery.

Key words: fetal health, maternal health, safe delivery

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