Objective To analyze the changing trend of cesarean section rate and indications of cesarean section before and after the implementation of the comprehensive two-child policy, to provide evidence-based evidence for monitoring safe hospital delivery data, promoting hospital medical quality, improving maternal health management, and optimizing health policies. Methods The clinical data of 34528 pregnant women delivered in a Provincial Maternal and child health care hospital before and after the implementation of the comprehensive two child policy (January 2014 to December 2019) were selected. A retrospective analysis of the changes in cesarean section rate and the indication ratio of cesarean section was made in the study. And use a questionnaire survey to understand the change in the degree of maternal cognition of delivery methods before and after the implementation of the policy, and analyze the factors that cause the change in cesarean section rate. Results After the comprehensive two-child policy was released, the rate of cesarean section in the hospital decreased significantly. The number of cesarean sections indicated by scar uterus, pregnancy complications and complications, placenta previa, and prevascular vessels increased significantly. The number of cesarean sections indicated by fetal distress, macrosomia, cephalopelvic disproportion, social factors and pelvic abnormalities was significantly decreased. After the implementation of the policy, the level of maternal cognition of delivery methods has been on the rise. Conclusion According to the changing trend of cesarean section indications, hospitals and relevant clinical departments should take effective measures to strengthen health education, actively promote childbirth analgesia, establish a natural delivery incentive mechanism, build a comprehensive network for critically ill pregnant women, and comprehensively guarantee the safety of pregnant women.