Non-Clinical Interventions to reduce overall cesarean sections
- Priority questions and outcomes
The population of interest comprised:
▪️ women seeking antenatal, labour and delivery care in health-care facilities (term, singleton, in vertex presentation with or without a prior cesarean);
▪️ families of pregnant women;
▪️ health-care professionals who work with expectant mothers (midwives, nurses and obstetricians); and
▪️ health-care facilities that provide maternity care; and
Interventions:
1. Opinion leaders to improve adherence to evidence based clinical guidelines
2. Education of healthcare professionals to improve adherence to evidence-based clinical guidelines
3. Mandatory second opinion for cesarean indication
4. Audit and feedback
5. Peer review
6. Continuous support in labour
7. 24-hour in-house obstetrician coverage
8. Midwife-led continuity-of-care model
9. Health education of women in pregnancy
10. Education of the community
11. Goal setting for cesarean rates
12. Public dissemination of cesarean rates
13. Hospital quality improvement programme
14. Targeted financial strategies for health-care professionals or health-care organizations.
15. Policies that limit financial/legal liability in case of litigation of healthcare professionals or organizations.
Comparator: usual care
Critical outcome:
1. Overall cesarean sections.
2. Repeat cesarean sections.
3. NTSV Cesarean sections.
➡️Related guidelines
This guideline is a companion to the guideline intended to provide recommendations on the best intrapartum care.
➡️Focus and approach
The focus of this guideline is non-clinical interventions for reducing cesareans.