ArticleAmerican journal of perinatology2019
A Prospective, Population-Based Study of Trends in Operative Vaginal Delivery Compared to Cesarean Delivery Rates in Low- and Middle-Income Countries, 2010-2016.
Article in American journal of perinatology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.
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Who cites it
22 citing papers in PubMed.
- Vacuum 5-step technique versus OdonAssist: Which is easier to learn for professionals without experience in assisted vaginal births? A simulation study.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2026Trial
- Trial
- Review
- Maternal and perinatal outcomes after vacuum-assisted vaginal delivery versus second-stage caesarean delivery in a generalist-run rural district hospital: A retrospective cohort study.South African family practice : official journal of the South African Academy of Family Practice/Primary Care · 2026Article
- Maternal morbidity following a trial of labor after cesarean birth: A scoping review of operative vaginal birth compared with cesarean birth in the second stage of labor.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2026Article
- Influence of instrument choice on fear of childbirth after assisted vaginal delivery: A secondary analysis of the Bergen birth study.Acta obstetricia et gynecologica Scandinavica · 2025Observational
- Obstetric Outcomes by Hospital Volume of Operative Vaginal Delivery.JAMA network open · 2025Article
- Trends and determinants of the use of episiotomy in a prospective population-based registry from central India.BMC pregnancy and childbirth · 2024Article
- Engaging women to set the research agenda for assisted vaginal birth.Health expectations : an international journal of public participation in health care and health policy · 2024Article
- A research agenda to improve incidence and outcomes of assisted vaginal birth.Bulletin of the World Health Organization · 2023Article
- Maternal complications and risk factors associated with assisted vaginal delivery.BMC pregnancy and childbirth · 2023Article
- Article
- Article
- Estimated frequency of instrumented vaginal delivery in Colombia between 2015 and 2019. Population registry-based cross-sectional studyRevista colombiana de obstetricia y ginecologia · 2022Article
- Changes in maternal risk factors and their association with changes in cesarean sections in Norway between 1999 and 2016: A descriptive population-based registry study.PLoS medicine · 2021Observational
- Article
- Prevalence of and characteristics associated with operative vaginal birth at Mizan-Tepi University Teaching Hospital.International health · 2021Article
- Pregnancy outcomes at Mizan-Tepi University Teaching Hospital: A Comparison to the Ethiopian Demographic and Health Surveys.Obstetrics and gynecology research · 2021Article
- Trends in cesarean delivery rates in primipara and the associated factors.BMC pregnancy and childbirth · 2020Article
- Perinatal outcomes of babies delivered by second-stage Caesarean section versus vacuum extraction in a resource-poor setting, Nigeria - a retrospective analysis.BMC pregnancy and childbirth · 2020Article
Corrections and comments
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Authors and funding
30 authors.
Funding
Abstract
objectiveFew data are available on cesarean delivery and operative vaginal delivery trends in low- and middle-income countries. Our objective was to analyze a prospective population-based registry including eight sites in seven low- and middle-income countries to observe trends in operative vaginal delivery versus cesarean delivery rates over time, across sites. STUDY
designA prospective population-based study, including home and facility births among women enrolled from 2010 to 2016, was performed in communities in Argentina, Democratic Republic of Congo, Guatemala, India, Kenya, Pakistan, and Zambia. Women were enrolled during pregnancy and delivery outcome data were collected.
resultsWe analyzed 354,287 women; 4,119 (1.2%) underwent an operative vaginal delivery and 45,032 (11.2%) delivered by cesarean. Across all sites with data for 7 years, rates of operative vaginal delivery decreased from 1.6 to 0.3%, while cesarean delivery increased from 6.4 to 14.4%. Similar trends were seen when individual country data were analyzed. Operative vaginal delivery rates decreased in both hospitals and clinics, except in the hospital setting at one of the Indian sites.
conclusionIn low- and middle-income countries, operative vaginal delivery is becoming less utilized while cesarean delivery is becoming an increasingly common mode of delivery.
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