[Unequal access to safe cesarean section - threat to global maternal health care]

Despite evidence that cesarean section rates above 10 percent at the population level do not reduce maternal or neonatal mortality, global rates continue to rise and are projected to reach 30 percent by 2030. The factors behind this increase are complex and vary across contexts, emphasizing the need for a local understanding in order to design and implement effective interventions to curb overuse. In contrast to many other high-income countries, Nordic countries exemplify how robust obstetric practices, midwifery led care and evidence-based guidelines can achieve excellent outcomes while maintaining low cesarean section rates. This success underscores the potential for healthcare systems worldwide to optimize cesarean use without compromising maternal and neonatal health.