Evidence-Based Labor and Delivery Management: Can We Safely Reduce the Cesarean Rate?

This article provides an overview of the approaches that might be used to safely reduce the cesarean rate. Although cesarean delivery may be a safe alternative to vaginal delivery, its use in 1 in 3 women giving birth is likely too high. The downstream impact of cesarean delivery on future pregnancies is likely not well-considered when the first cesarean is being performed. Through quality improvement, environmental changes will allow clinicians to adopt the range of practices described. However, without such environmental changes, clinicians may not be able to change their own practice patterns given environments in which they practice.