A recent study published in Nature Medicine has found that implementing the World Health Organization’s (WHO) Labor Care Guide (LCG) could help to improve women’s care during childbirth and reduce unnecessary cesarean sections, without causing harm. Cesarean sections currently account for more than 1 in 5 childbirths globally, with the numbers predicted to rise to one-third of all births in the next decade. While cesarean sections can be lifesaving when performed for medical reasons, they also come with inherent risks.
The study, titled “Effects of the WHO Labour Care Guide on cesarean section in India: a pragmatic, stepped-wedge, cluster-randomized pilot trial,” is the first randomized trial of the WHO’s LCG. It was conducted in four hospitals in India to evaluate the implementation of the novel LCG strategy compared to routine care.
The lead author of the paper, Professor Joshua Vogel, who is the Burnet Institute Co-Program Director of Maternal, Child and Adolescent Health, stated that the study demonstrated the feasibility of implementing the LCG into routine clinical care, even in busy, limited-resource settings. The LCG was developed by the WHO to improve clinical and supportive care for women during childbirth, but prior to this study, its effects on women and their babies were uncertain.
Professor Vogel emphasized that the LCG has the potential to reduce unnecessary cesarean sections, which pose health risks for both mothers and their babies. In recent years, there has been a trend in healthcare providers being more “interventional” during birth, resulting in high rates of cesarean sections, the use of labor-inducing drugs, and episiotomies in many countries. While cesarean sections can improve health outcomes when used appropriately, they are often performed without clear medical necessity. The research showed that when the LCG was well-implemented, there were reductions in cesarean section rates without any additional harm.
The collaborative research involved the participation of the Burnet Institute, international hospitals, universities, and research groups in India and Argentina. The aim of the study is to guide future trials and reverse the global trend of rising cesarean section rates.
Trials like this provide critical evidence that can reassure women, their families, healthcare workers, and policymakers that the implementation of the LCG in their setting will not lead to unforeseen harm. With the rising rates of cesarean sections worldwide, it is crucial to explore strategies that can improve women’s care during childbirth and reduce unnecessary interventions. The WHO’s Labor Care Guide shows promise in achieving this goal and warrants further investigation and implementation.
1. Source: Coherent Market Insights, Public sources, Desk research
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