Recent trends in cesarean section deliveries in Canada were explored using 1970-1988/89 hospitalization data from Statistics Canada's morbidity data base. The rate in Canada increased from 5.8 cesarean sections per 100 hospital deliveries in 1970 to 19.5 in 1988/89 and paralleled the increase in rates seen in the United States, which went from 5.5 to 24.7 during the same period. Canada had the second highest rate among the countries studied and in the last year of the study the Canadian rate was almost double that of the United Kingdom. Provincially the rates were highest in Newfoundland (23.3) and lowest in Manitoba (15.5). Cesarean sections were more frequent among women aged 35+ (27.3 per 100 hospital deliveries) compared with (13.9) for women under 20 years of age. Vaginal births after a previous cesarean increased significantly during the last 10 years from 3 per 100 previous cesarean sections in 1979/80 to 15.6 in 1988/89, perhaps indicating a significant shift in obstetric practice.