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OBJECTIVES The objective of this analysis was to review indication and utilization of cesarean birth among Robson Classification of Cesarean Birth subgroups. METHODS This study was a prospective hospital-based cross-sectional analysis of a convenience sample of 1,000 women who delivered Mizan Tepi University Teaching Hospital in the summer and fall of 2019. RESULTS Data on mode of delivery was available for 993 women, 23.4% of which underwent cesarean birth. The leading indication for cesarean birth was a fetal indication (46.2%), followed by a maternal indication (35.9%); elective cesarean birth was the indication for one cesarean birth. Robson Groups 1 and 3 (primary cesarean among nulliparous and multiparous women) accounted for the largest proportion of the overall population of women (30.2% and 36.8%), and cesarean birth rates within these groups were 19.4% and 16.1%, respectively. In all remaining groups, cesarean birth rates were at least 17.1%, ranging to as high as 100.0%. Pre-labor cesarean was highest in Robson Group 5 (multiparous women with a history of cesarean birth). CONCLUSION Further analysis of risk factors associated with cesarean birth in women whose labor was induced or augmented, or those undergoing preterm birth, might offer additional target risk factors to modify.