Can we reduce the caesarean section rate?

Caesarean section rates continue to be an issue of great concern to many midwives, obstetricians, women, and society as a whole. With an increase in women requesting caesarean sections, the responsibility for the caesarean section rate needs to be re-defined. There is a need to improve the routine information collection on all aspects of childbirth. There is also a need to adopt standard classification systems so that comparisons and improvement of care can take place. Caesarean section rates should no longer be thought of as being too high or too low, but rather whether they are appropriate or not, after taking into consideration all the relevant information. This will require statutory, standardized collection of information. Maternal satisfaction has now become one of the most significant outcome factors after childbirth and must be taken into consideration when implementing any changes in childbirth. Finally, caesarean section rates must no longer be considered in isolation from other changes taking place in society.