A Cluster-Randomized Trial to Reduce Cesarean Delivery Rates in Quebec

This multicenter, cluster-randomized trial showed that an intervention involving audits of indications for cesarean delivery, feedback, and implementation of best practices resulted in a significant but small reduction in the cesarean delivery rate as compared with usual care. Rates of cesarean delivery are high in developed countries. 1 – 3 In Canada, these rates increased from 21.2% to 28.0% between 2000 and 2008 and remained stable until 2011. 4 – 6 High rates of cesarean delivery are of substantial concern owing to the potential harm to the mother and her baby associated with a medically unnecessary cesarean delivery and to the related costs of health care. 7 – 15 Providing evidence-based guidance to health professionals regarding the appropriate selection of women who could benefit from cesarean delivery is now a priority. Systematic reviews of strategies designed to reduce cesarean delivery rates and to improve . . .