RESUMO
BACKGROUND: the high incidence of cesarean section is a world health problem, and Mexico is not the exception. The purpose of the clinical practice guidelines is to establish accurate directions on delivery by cesarean section, diminishing its unjustified practice. The Regional General Hospital and Medical Family Unit 2 of the Instituto Mexicano del Seguro Social in Zacapu, Michoacán has 70 % of cesarean section rate, it is the double of the country average. The aim was to know causes of cesarean section. METHODS: a retrospective, non-probabilistic analysis of 127 patients attended along two months. The incidence of cesarean section and causes were recorded. A statical descriptive analysis was done. RESULTS: ninety cesareans (70.9) % were performed in 127 patients; 44.4 % of these were performed in primiparous women. The most frequent reason was repeated cesarean in 27.8 %, cephalopelvic disproportion in 25.6 %, and fetal distress in 14.4 %. CONCLUSIONS: the high incidence of cesarean section in primiparous women suggests a careful review of its indications, mainly the cephalopelvic disproportion diagnosis.