Trial shows promise in fight against unnecessary C-sections

C-sections now account for more than one in five births worldwide, and this figure is expected to rise over the next decade to a third of all births, according to the World Health Organization (WHO).

When performed for medical reasons, C-sections can save lives and are an essential part of good quality medical care, but they can also carry inherent risks.

In a recent study published in Natural medicineResearchers found that implementing the WHO Labor Care Guide (LCG) could help improve the care of women during childbirth and reduce unnecessary cesarean sections, without causing harm.

The paper titled “Effects of the WHO Labor Care Guide on Caesarean Section in India: A Pragmatic, Stepped, Cluster Randomized Pilot Trial” is the world’s first randomized trial of the WHO LCG.

Researchers conducted a pilot trial in four hospitals in India to evaluate the implementation of the new LCG strategy, compared to routine care.

Co-director of the Burnet Institute’s Maternal, Child and Adolescent Health Program and lead author of the paper, Professor Joshua Vogel, said the study showed it was possible to implement LCG into clinical care routine, including in busy and resource-limited settings.

“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, to date, we weren’t sure about its effects on women and their babies,” he said. said.

Professor Vogel said LCG had the potential to reduce unnecessary caesarean sections, which carry health risks for mothers and their babies.

“In recent decades, there has been a widespread trend of health care providers being more “interventional” during childbirth – this is reflected in high rates of cesarean sections, increasing labor with medications and the episiotomies that we see in many countries,” he said.

“When used at the right time, C-sections can improve health outcomes, but they are often used without a clear medical need. Our research showed that when LCG was implemented well, cesarean section rates were reduced, without additional harm.

“A trial like this generates crucial evidence that can reassure women, their families, health workers and policy makers that using LCG in their setting will not cause unintended harm.”

It is hoped that collaborative research between Burnet, international hospitals, universities and research groups in India and Argentina will guide future trials and begin to reverse the global trend of rising C-section rates.