ArticlePloS one2016
Obstetricians' Opinions of the Optimal Caesarean Rate: A Global Survey.
Article in PloS one, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- Perspectives of obstetricians and midwives on the preference for caesarean deliveries: a qualitative exploration in Andhra Pradesh, India.BMC pregnancy and childbirth · 2025Article
- Mode of Delivery in Greece: A Study of Obstetricians' Personal Preferences Regarding Delivery of Their Offspring.Journal of clinical medicine · 2025Article
- Obstetricians and midwives perspective of the alarming high cesarean section rates in Greece and worldwide.Heliyon · 2024Article
- Students' Attitudes Towards Birth Decisions.Maedica · 2021Article
- Risk of complicated birth at term in nulliparous and multiparous women using routinely collected maternity data in England: cohort study.BMJ (Clinical research ed.) · 2020Article
- Changing Scenario in Indian Contraceptive Methods: A Glimpse Through a Tertiary Hospital Statistics.Journal of obstetrics and gynaecology of India · 2019Article
- Improving Maternal and Neonatal Health by a Midwife-led Continuity Model of Care - An Observational Study in One Governmental Hospital in Palestine.EClinicalMedicine · 2019Article
- Obstetrical providers' preferred mode of delivery and attitude towards non-medically indicated caesarean sections: a cross-sectional study.BJOG : an international journal of obstetrics and gynaecology · 2018Article
- Preference for cesarean section in young nulligravid women in eight OECD countries and implications for reproductive health education.Reproductive health · 2017Article
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3 authors.
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Abstract
backgroundThe debate surrounding the optimal caesarean rate has been ongoing for several decades, with the WHO recommending an "acceptable" rate of 5-15% since 1997, despite a weak evidence base. Global expert opinion from obstetric care providers on the optimal caesarean rate has not been documented. The objective of this study was to examine providers' opinions of the optimal caesarean rate worldwide, among all deliveries and within specific sub-groups of deliveries.
methodsA global online survey of medical doctors who had performed at least one caesarean in the last five years was conducted between August 2013 and January 2014. Respondents were asked to report their opinion of the optimal caesarean rate--defined as the caesarean rate that would minimise poor maternal and perinatal outcomes--at the population level and within specific sub-groups of deliveries (including women with demographic and clinical risk factors for caesareans). Median reported optimal rates and corresponding inter-quartile ranges (IQRs) were calculated for the sample, and stratified according to national caesarean rate, institutional caesarean rate, facility level, and respondent characteristics.
resultsResponses were collected from 1,057 medical doctors from 96 countries. The median reported optimal caesarean rate was 20% (IQR: 15-30%) for all deliveries. Providers in private for-profit facilities and in facilities with high institutional rates reported optimal rates of 30% or above, while those in Europe, in public facilities and in facilities with low institutional rates reported rates of 15% or less. Reported optimal rates were lowest among low-risk deliveries and highest for Absolute Maternal Indications (AMIs), with wide IQRs observed for most categories other than AMIs.
conclusionsThree-quarters of respondents reported an optimal caesarean rate above the WHO 15% upper threshold. There was substantial variation in responses, highlighting a lack of consensus around which women are in need of a caesarean among obstetric care providers worldwide.
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