Interventions in Reducing Caesarean Section in the World: A Systematic Review

Area of Science:

• Obstetrics and Gynecology
• Public Health
• Healthcare Management

Background:

• Unindicated caesarean sections present significant challenges for families, healthcare providers, and resources.
• These procedures carry potential side effects for both mothers and neonates compared to vaginal birth.

Purpose of the Study:

• To systematically review global interventions aimed at reducing caesarean section rates.
• To identify effective strategies for decreasing non-medically indicated caesarean births worldwide.

Main Methods:

• A systematic review of studies published between 2000 and 2018.
• Searches conducted across major databases (Embase, PubMed, Scopus, Web of Science, Science Direct) and grey literature.
• Inclusion and exclusion criteria were applied to select 19 relevant studies from 5,559 initial records.

Main Results:

• Interventions included specialist and patient education (e.g., Six Sigma), guideline modifications, redefining labor stages, and promoting natural and painless childbirth.
• Strategies were categorized into educational and managerial approaches.
• These interventions demonstrated potential to modify physician behavior and pregnant women's attitudes.

Conclusions:

• Educational and managerial strategies are effective in reducing caesarean section rates.
• Implementing these interventions can positively influence healthcare provider practices and patient expectations.
• Authorities should prioritize and support efforts to decrease medically unnecessary caesarean births.