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Introduction: The seventh instruction of the Health System Reform Plan has been implemented since May 05, 2014 in order to promote natural delivery and reduce unnecessary cesarean rates. The present study aimed to investigate the cesarean section frequency and its causes and after the implementation of the Health System Reform Plan. Materials and Methods: The present descriptive study analyzed the existing data collected by questionnaires, checklists, and interviews. To this end, 1240 samples were systematically selected based on file number from May 05, 2014 to May 06, 2015. The data were analyzed using frequency, percentage, mean, Chi-square test, Pearson’s test, and Cramer test. Results: The cesarean section rate was 47.57% before implementing Health System Reform Plan, but it reduced to 38.70% after the implementation. Accordingly, there was a significant difference between the two groups (p=0.02). The two groups had a significant difference in the causes of elective cesarean section (p=0.01). However, there was no significant difference between the two groups regarding the causes of emergency cesarean section (p=0.08). After the implementation of the Health System Reform Plan, no case of elective cesarean section was performed (p=0.01). Conclusion: According to the results of the study (8.87% reduction in cesarean section), Health System Reform Plan succeeded in achieving its specific goal in the first year of its implementation. [ABSTRACT FROM AUTHOR]