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Background: Bangladesh recently became a middle income country and despite of its relatively low skilled birth attendance (26.5%) nevertheless experience a rise in caesarean section (CS) rate. But now the rate of CS increased almost seven fold from 3.5% in 2004 to 23% in 2016. Objective: To find out the cause and incidence of caesarean section among the primigravid mother in Rajshahi medical college hospital performed in between January 2017 to December 2017. Methods: This prospective type of observational study was performed in Rajshahi Medical College Hospital (RMCH) over a period of one year from January 2017 to December 2017. All primigravida who underwent caesarean section in RMCH were included. Result: During the study period there were 11018 deliveries. Overall CS rate was 40.98%. The rate in primi was 30.70% and last year it was 25.58%. Conclusion: The vast majority of CS was not medically indicated. A number of policies and program had been launched to counteract this increasing rate of CS but virtually there was no impact. 1 Assistant Professor, Department of Obs & Gynae, Rajshahi Medical College, Rajshahi 2 Assistant Registrar, Department of Obs & Gynae, Rajshahi Medical College Hospital 3 Indoor Medical Officer, Department of Obs & Gynae, Rajshahi Medical College Hospital 4 Resident, Department of Obs & Gynae, Rajshahi Medical College Hospital 5 Junior Consultant, Department of Obs & Gynae, Rajshahi Medical College Hospital 6 Junior Consultant, Department of Obs & Gynae, Rajshahi Medical College Hospital Introduction The fundamental changes in the attitude of caesarean section among patients and doctors are due to scientific progress, social and cultural changes and in particular legal changes. Nowadays consensus around the indications for CS has changed and in many countries CS was done due to physical anxiety about the delivery or even mother’s wish to have a CS in the absence of anymedical indication.Nevertheless the reasons for increasingly liberal attitudes towards caesarean section are diverse and not easily distinguishable. A pregnant woman is exposed to many risks that may put both lives of herself and her unborn child in danger. In recent years, a number of factors have been under consideration as possible cause on the rising cesarean section rate. Changing risk profiles among increasingly older primipara are often considered as a reason for the

Primary Causes of Caesarean Section among the Primigravida in Rajshahi Medical College Hospital