Beyond medical indications: exploring nonclinical cesarean section from healthcare providers’ perspectives in southeast Iran

BACKGROUND: The rate of cesarean delivery in Iran has increased substantially in recent decades, exceeding World Health Organization recommendations and influenced by multiple individual and systemic factors. This study explored factors influencing nonclinical cesarean section from the perspectives of healthcare providers in southeast Iran. METHODS: This qualitative study used a conventional content analysis approach and included 16 participants (nine midwives and seven obstetricians). Data were analyzed using Krippendorff's analytical framework and managed with MAXQDA software. RESULTS: The main theme identified was cultural, legal, educational, health system and economic influences on the choice of delivery method. Eleven subthemes were grouped into four interrelated domains: sociocultural and informational factors, health system and professional influences, legal and policy contexts, and educational and economic determinants. CONCLUSIONS: Nonclinical cesarean section is a multidimensional phenomenon; therefore, multifaceted interventions at individual, professional, and policy levels are required to reduce its prevalence.