Cesarean sections currently account for more than 1 in 5 births globally, with numbers expected to increase over the next decade to a third of all births. birthsaccording to the World Health Organization (WHO).
When performed for medical reasons, caesarean sections can be lifesaving and are an essential component of good quality medical care, but they can also carry inherent risks.
In a recent study, researchers found that implementing the WHO Labor Care Guide (LCG) could help improve women's care during childbirth and reduce unnecessary caesarean sections, without causing harm.
The results of the study were published in Nature Medicine.
How to reduce unnecessary caesarean sections
The article, “Effects of WHO Labor Support Guidance on Cesarean Section in India: A Pragmatic, Stepwise, Cluster-Randomized Pilot Study,” is the world's first randomized trial on WHO LCG.
The researchers conducted the pilot trial in four hospitals in India to evaluate the implementation of the new LCG strategy, compared to routine care.
Burnet Institute Co-Program Director for Maternal, Child and Adolescent Health and lead author of the paper, Professor Joshua Vogel, said the study demonstrated that it is possible to implement LCG into routine clinical care , even in crowded contexts and with limited resources.
“The LCG was published by WHO to improve clinical and supportive care for women giving birth worldwide. Although it was developed to align with the best available evidence, until now we were unsure of its effects on women and their babies,” she said. she said.
Professor Vogel said LCG has the potential to reduce unnecessary caesarean sections, which pose health risks to mothers and their babies.
“In recent decades there has been a generalized tendency for health workers to be more 'interventional' during childbirth: this is demonstrated by the high rates of caesarean sections, the increase in drug-assisted labor and episiotomy that we see in many countries,” he said.
“When used at the right time, cesarean sections can improve health outcomes, but they are often used without a clear medical necessity. Our research has shown that when LCG was well implemented, reductions in cesarean section rates occurred, without additional harm.
“A study like this generates critical evidence that can reassure women, their families, healthcare professionals and policymakers that the use of LCG in their context will not cause unexpected harm.”
It is hoped that collaborative research between Burnet, international hospitals, universities and research groups in India and Argentina can guide future studies and begin to reverse the worldwide trend of increasing caesarean section rates.
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