 In Bangladesh, Caesarean sections, CS, are increasing at a rapid rate, but there is still a large gap between those who can afford it and those who cannot. In 2004, only 3.88% of births were via CS, but by 2017-18 this had increased to 33%. This indicates that more people are able to access the procedure, which is a positive development. However, the study also shows that women from rural areas, with no formal income-generating activity, and from low-income households are less likely to receive a CS than other women. This suggests that there is a double burden of CS use in Bangladesh, where some women are accessing the procedure unnecessarily, while others are unable to do so due to their socioeconomic background. To address this issue, the government should monitor the use of CS procedures and provide support to those who need it on medical grounds. This article was authored by M.D. Nourazman Khan, M.D. Awal Kabir, Asma Ahmad Sharif and others.