A New Trial Opens Possibilities of Avoiding Unnecessary Cesarean Operations


A trial exhibits potential in tackling unnecessary cesarean sections, a procedure that currently represents over 20% of global childbirths, with projections from the World Health Organization (WHO) anticipating a further increase to one-third of all births in the next decade.

When conducted for medical necessities, cesarean sections can be life-saving and constitute a crucial element of high-quality medical care; however, they also come with inherent risks. A recent study, published in Nature Medicine, indicates that the implementation of the World Health Organization’s (WHO) Labor Care Guide (LCG) has the potential to enhance women’s care during childbirth, leading to a reduction in unnecessary cesarean sections without causing harm. This paper, titled “Effects of the WHO Labour Care Guide on cesarean section in India: a pragmatic, stepped-wedge, cluster-randomized pilot trial,” represents the world’s first randomized trial of the WHO’s LCG.

Professor Joshua Vogel, the lead author of the paper and Co-Program Director of Maternal, Child, and Adolescent Health at the Burnet Institute, emphasized that the study demonstrated the feasibility of integrating the Labor Care Guide (LCG) into routine clinical care, even in busy and resource-limited settings.

“The WHO’s Labor Care Guide (LCG) was introduced to enhance clinical and supportive care for women during childbirth globally. Although it was designed based on the best available evidence, its impact on women and their babies was uncertain until now,” stated Professor Vogel. He highlighted the potential of the LCG to decrease unnecessary cesarean sections, thereby mitigating health risks for both mothers and infants.