en Midwifery Orginal research <strong><em>Background:</em></strong> The increased prevalence of cesarean section (C&ndash;section) is a global epidemic.<br> <strong><em>Objectives: </em></strong>The aim of this study was to determine the prevalence and demographic, fertility, and childbirth-related factors of C&ndash;section in<ins cite="mailto:Nanotech0" datetime="2018-08-04T17:06"> Zanjan province,</ins> Iran<ins cite="mailto:Nanotech0" datetime="2018-08-04T17:06">,</ins>-<del cite="mailto:Nanotech0" datetime="2018-08-04T17:06">Zanjan province in the period since</del><ins cite="mailto:Nanotech0" datetime="2018-08-04T17:06">from</ins> 21 March 2014 <del cite="mailto:Nanotech0" datetime="2018-08-04T17:07">through the</del><ins cite="mailto:Nanotech0" datetime="2018-08-04T17:07">to</ins> 19 March 2016.<br> <strong><em>Methods:</em></strong> This study was a descriptive analytic study, carried out in <del cite="mailto:Nanotech0" datetime="2018-08-04T17:08">the </del>2014&ndash;2016, which gathered 41, 265 registered childbirth data in Zanjan province hospitals<ins cite="mailto:Nanotech0" datetime="2018-08-04T17:08"> and</ins><del cite="mailto:Nanotech0" datetime="2018-08-04T17:08">,</del> from country electronic childbirth register system. Data were analyzed using descriptive, univariate and multivariate logistic binominal regression.<br> <strong><em>Results</em></strong><strong>:</strong> <ins cite="mailto:Nanotech0" datetime="2018-08-04T17:10">according to the findings, </ins><del cite="mailto:Nanotech0" datetime="2018-08-04T17:10">The</del><ins cite="mailto:Nanotech0" datetime="2018-08-04T17:10">the</ins> prevalence of C&ndash;section was 40.1%. The odds of having C&ndash;section <ins cite="mailto:J.G." datetime="2018-08-09T09:16">went up </ins><del cite="mailto:J.G." datetime="2018-08-09T09:16">raised <ins cite="mailto:Nanotech0" datetime="2018-08-04T17:11">enhanced</ins></del> with increasing maternal age (OR=1.026), gravidity (OR=0.670), and gestational age (OR=0.093), while it decreased with an increased parity, end educational level up to high school graduate<ins cite="mailto:Nanotech0" datetime="2018-08-04T17:14">.</ins><del cite="mailto:Nanotech0" datetime="2018-08-04T17:13"> decreased the odds of having C&ndash;section, </del><del cite="mailto:Nanotech0" datetime="2018-08-04T17:14">while </del><ins cite="mailto:Nanotech0" datetime="2018-08-04T17:14">&nbsp;In contrast, </ins>higher educational (OR=3.064) level increased the odds of having C&ndash;section. Living in the urban areas (OR=1.855) also increased the odds<ins cite="mailto:Nanotech0" datetime="2018-08-04T17:14"><del cite="mailto:J.G." datetime="2018-08-09T09:16">./degrees/rates/amouts</del></ins> of C&ndash;section. Diabetes (OR=1.990), preeclampsia or eclampsia &nbsp;(OR=2.350), hypertension (OR=1.983), and thyroid disorders (OR=2.289) increased the odds of having C&ndash;section. Newborns <del cite="mailto:Nanotech0" datetime="2018-08-04T17:15">with </del>with low birth weight (OR=1) and macrosomia (OR=2.663), and boys (OR=1.107) were delivered more <del cite="mailto:Nanotech0" datetime="2018-08-04T17:15">by </del><ins cite="mailto:Nanotech0" datetime="2018-08-04T17:15">via </ins>C&ndash;section. <del cite="mailto:Nanotech0" datetime="2018-08-04T17:15">f </del><ins cite="mailto:Nanotech0" datetime="2018-08-04T17:15">Among </ins>the interventions during labor, induction (OR=1.131) and stimulation of labor (OR=0.269) reduced the odds of C&ndash;section (P<0.05).<br> <strong><em>Conclusion:</em></strong> C&ndash;section rate is very high in Iran and its association with different variables can be a basis for planning and policymaking <ins cite="mailto:Nanotech0" datetime="2018-08-04T17:16">in order </ins>to reduce the C&ndash;section rate<ins cite="mailto:Nanotech0" datetime="2018-08-04T17:17">, particularly</ins> in <del cite="mailto:Nanotech0" datetime="2018-08-04T17:17">this </del><ins cite="mailto:Nanotech0" datetime="2018-08-04T17:17">Zanjan </ins>province. cesarean section, prevalence, risk factors, Zanjan 47 55 http://nmcjournal.zums.ac.ir/browse.php?a_code=A-10-610-2&slc_lang=en&sid=1 Arezoo Safaei nezhad a.safaei20@yahoo.com 10031947532846007706 10031947532846007706 No MSc. student in midwifery counseling. Dept. of Midwifery, School of Nursing and Midwifery, Zanjan University of Medical Sciences, Zanjan, Leila Rastegari lrastegari818@gmail.com 10031947532846007707 10031947532846007707 No MSc. Dept. of Midwifery, School of Nursing and Midwifery, Zanjan University of Medical Sciences, Zanjan, Iran Roghieh Kharaghani r.kharaghani@yahoo.com 10031947532846007708 10031947532846007708 Yes PhD. in Reproductive Health, Dept. of Midwifery, Assistant Professor, School of Nursing and Midwifery, Zanjan University of Medical Sciences, Zanjan, Iran