Featured Review: Non-clinical interventions for reducing unnecessary caesarean section

With numbers of caesarean sections increasing world wide this review looks at non-clinical interventions for reducing caesarean sections.

Caesarean section is an operation used to prevent and reduce complications of childbirth. While it can be a life‐saving procedure for both the mother and baby, caesarean section is not without harm and should only be carried out when necessary. The number of caesarean sections performed has been increasing worldwide. The aim of this updated Cochrane Review was to find out whether non-clinical interventions, which aim to reduce unnecessary caesarean sections, such as providing education to healthcare workers and mothers, are safe and effective. 

The review team from Cochrane Effective Practice and Organisation of Care  studied a wide range of non-clinical interventions drawn from 29 studies, mostly in high-income countries. 

Based on high‐quality evidence, they found the following interventions reduce caesarean section rates without adverse effects on maternal or neonatal outcomes. These interventions are mainly aimed at healthcare professionals (nurses, midwives, physicians) and involve using: clinical guidelines combined with mandatory second opinion for caesarean section indication; clinical guidelines combined with audit and feedback about caesarean section practices; and opinion leaders (obstetrician/gynaecologist) to provide education to healthcare professionals.