No single strategy is uniformly successful in reducing cesarean section
Research Activities, December 2012, No. 388
A new research review from the Agency for Healthcare Research and Quality (AHRQ) that compared strategies for reducing cesarean section (c-section) birth in low-risk women found that few studies have been done on this topic and no single strategy is uniformly successful in reducing c-sections.
Among the few studies addressing prenatal strategies for reducing cesarean birth, one strategy was found to be effective—the treatment of the cervix with hyluronidase in the clinic at term to promote cervical softening. Active management of labor, labor coach support, fetal assessment, and amnioinfusion strategies are all strategies conducted during labor that showed statistically significant reduction in cesarean births. Of these strategies, active management of labor showed the greatest reduction, with 2.8 to 7.4 percent decreases. However, the strength of evidence for these studies was predominantly insufficient to low.
Health system strategies implemented with the specific goal of reducing c-sections also showed statistically significant reductions in cesareans. However, most strategies had more than one component, making it difficult to determine which of the components were associated with reductions. Nearly 1 in 3 births in the United States is a cesarean section, and the number of c-section births increased 53 percent from 1996 to 2007. The low to insufficient strength of evidence available for all strategies means that the review could not determine a widely appropriate approach to reduce the use of cesarean among low-risk women in the United States.
Details on current research on the effectiveness of strategies to reduce cesarean section can be found in the research review Strategies to Reduce Cesarean Birth in Low-Risk Women. To access this review and other materials that explore the effectiveness and risks of treatment options for various conditions, visit the AHRQ Effective Health Care Program Web site.