Background: Caesarean section (CS) rates are increasing worldwide; rates in the private sector in South Africa are reported to be particularly high. To the best of our knowledge there has been no recent audit of Caesarean sections performed by the private health sector in KwaZulu-Natal. The aim of this study was to carry out an audit of CS in a private practice.

Methods: An audit of the patient records over a period of one year was done. No personal identifiers were noted or reported on. All relevant clinical data were pooled and used to analyse the clinical information.

Results: There were 364 deliveries in the study period and 209 of these were CS, giving a rate of 60.4%. Most of the caesarean sections were carried out because of a previous CS; maternal request and HIV status also contributed to the high rate.

Conclusion: The high CS rate in private practice is probably a window to the increased rates of Caesarean section being performed worldwide. This high rate is in keeping with trends in countries such as South America, and is considerably higher than the ideal rate of 10 to 15% in low-risk obstetric populations suggested by the WHO.