• J Naiden and P Deshpande.
• Department of Obstetrics, Yakima Valley Memorial Hospital, Washington, USA.
• Am. J. Obstet. Gynecol. 2001 Jun 1; 184 (7): 1535-41; discussion 1541-3.

ObjectiveOur objective was to analyze the statistics on cesarean delivery rates and the factors that have led to a reduction in these rates.Study DesignA retrospective analysis was done of delivery statistics from a 10-year period, January 1, 1989, to December 31, 1998. We investigated the changes made in the methods of delivery during the study period. The data were divided into 1-year periods and analyzed by chi(2) tables.ResultsThe overall cesarean delivery rate decreased from 16.59% to 10.92%; the primary cesarean delivery rate decreased from 9.22% to 7.11% and the repeated cesarean delivery rate from 7.37% to 3.81%. All these decreases were statistically significant. An increase in the rate of active management of labor by increasing oxytocin use and encouraging a trial of labor after previous cesarean delivery was also statistically significant. No changes in the outcome were observed in terms of neonatal morbidity and mortality rates.ConclusionWe found that our working plan for management of labor and delivery yielded and maintained a successful decline in the cesarean delivery rates without any negative effect on neonatal or maternal mortality rates. This low rate was maintained for a 10-year period.

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