This study systematically reviews the prevalence, determinants, and socio-cultural influences on decision-making regarding caesarean section (CS). The objectives include examining CS prevalence across socio-economic and geographical contexts, exploring socio-cultural and economic influences on attitudes towards CS, and identifying key barriers and facilitators affecting CS decision-making. A scoping review was conducted following PRISMA guidelines, with data sourced from PubMed, Scopus, CINAHL, Web of Science, Embase, and Google Scholar. A total of 25 peer-reviewed studies published between 2018 and 2024 met the inclusion criteria. Findings reveal that urbanisation, education, socio-economic status, and prior CS history significantly influence CS acceptance. While educated women and those with prior CS experiences exhibit positive attitudes, cultural beliefs, financial constraints, and fear of surgical complications deter many. Preference for vaginal delivery post-CS underscores economic and societal influences, while healthcare provider recommendations, family support, and knowledge levels play a crucial role in CS decision-making. The study concludes that addressing socio-cultural barriers, enhancing public health education, and improving healthcare infrastructure can facilitate informed choices regarding CS. It recommends further nursing research into culturally tailored health education, healthcare provider influence, and patient-centred interventions to mitigate financial, emotional, and policy-related barriers to CS acceptance.

Keywords: Caesarean section, decision-making, socio-cultural influences, healthcare access, maternal health, public health education,

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