TY - JOUR T1 - Once therapeutic turns into elective: a cross-sectional analysis of cesarean section trends in İstanbul’s private hospitals AU - Şevik, İrem AU - Yasin, Yeşim AU - Dinç, Demet AU - Cosgun, Erdal PY - 2025 DA - August Y2 - 2025 DO - 10.20518/tjph.1599520 JF - Turkish Journal of Public Health JO - TJPH PB - Halk Sağlığı Uzmanları Derneği WT - DergiPark SN - 1304-1088 SP - 163 EP - 174 VL - 23 IS - 2 LA - en AB - Objective: Türkiye has one of the highest cesarean section (CS) rates among OECD countries, with private hospitalsperforming the majority of CSs. This study aims to examine trends in mode of delivery and associated factors in two privatehospitals in İstanbul between 2015 and 2020.Methods: In this registry-based cross-sectional study, data from 11,885 births were analyzed. Hospital 1 operated with aSocial Security Institution (SGK) contract, while hospital 2 served only with private financing. Data included delivery type,antenatal visits, maternal age and health insurance. Statistical analyses included chi-square, independent samples t-test,Mann-Whitney U test, Kruskal-Wallis, and Pearson correlation tests (p<0.05).Results: Overall, 73.7% of deliveries were by CS. The rate declined from 78.9% in 2015 to 69.7% in 2020. CS rates werehigher in hospital 1 (77.9%) than in hospital 2. Only 15.5% of CSs were medically indicated. CS was significantly associatedwith higher maternal age (32.8 vs. 31.7 years; p<0.001). Women who delivered vaginally attended more antenatal visits(10.6 vs. 9.9; p=0.001). The number of antenatal visits declined sharply in 2020 (9.4 vs. 10.2 in 2019).Conclusion: Despite a modest decline over time, CS rates remained high in both private hospitals studied, particularlyin the one contracted with SGK. The findings suggest that demographic, institutional, and healthcare utilization factorsinfluence CS practices. 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