Background: Elective Caesarean Section is safer for both mother and fetus compared to emergency caesarean sections. Paradoxically, emergency caesarean sections continue to form the bulk of caesarean deliveries in our facility.

Objective: The aim of this study is to determine caesarean section rate, its indications, and ascertain the trend as well as complications associated with elective caesarean section in our setting.

Methodology: This was a retrospective study of all patients that had caesarean section in Federal Medica Center, Katsina from January 1st 2008 to December 31st 2012. Data on the number and type of caesarean section, age of patients, the indication for elective caesarean section as well as known complications were extracted and analyzed.

Results: There were 11,315 deliveries during the study period, out of which 1,585 were by caesarean sections, with a caesarean section rate of 14%. Of all the patients that had caesarean sections, 1,324 (83.5%) were emergency, while 261 (16.5%) were done electively. There was a slight increase in elective caesarean section rate from 2% in 2009 to 2.5% and 2.6% in 2010 and 2011 respectively.

Repeat caesarean section was the commonest indication for elective procedure (27.6%), followed by abnormal presentations/ lie (14.6%) and fetal macrosomia (13.8%). The commonest complication was postpartum anaemia (9.6%).

Conclusion: Caesarean section rate was high (14%), with elective procedure contributing to16.5% of cases and accounting for 1 of every 6 procedures. The commonest indication was two or more previous caesarean sections, with postpartum anaemia as the most frequent complication.