Quali-Dec Project

Context and objectives

Cesarean section or vaginal delivery ? A GUIDED AND ACCOMPANIED CHOICE

Let’s give women, obstetricians and midwives the best tools to make important decisions on how to give birth.

Global Context

It is estimated that 29.7 million (21.1%) of the world’s births were delivered by caesarean section in 2015, it is almost double the number of births with this method in 2000 (16 million or 12.1%).
Despite long-standing international concerns and debates, the proportion of births by caesarean section continues to rise. This trend is not limited to high-income countries, but is largely confined to low- and middle-income countries.

In Latin America and the Caribbean in particular, it is up to ten times more frequent (44.3%) than in Africa (4.1%).

Source : Global epidemiology of use of and disparities in caesarean sections (Boerma et al.)

Our objectives

The overuse of Caesarean sections can no longer be seen solely as the result of inappropriate clinical practices during childbirth.

Non-clinical factors such as social, cultural and structural influences have emerged as important potential factors and must be taken into account to effectively address this growing problem. Non-clinical interventions have been shown (mainly in high-income countries) to reduce Caesarean section rates safely.

We propose a multi-faceted intervention simultaneously targeting clinicians, women, their relatives and health institutions to reduce the practice of non-medically justified caesarean sections in four countries (Argentina, Burkina Faso, Thailand and Vietnam).

The QUALI-DEC project was designed to improve the decision-making for a caesarean section. It provides pregnant women, their relatives and healthcare providers with practical tools that will guide their choice of the most appropriate mode of birth.

The QUALI-DEC project will benefit to pregnant women with a single fetus in cephalic presentation, who have reached at least 37 weeks’ gestation, with no previous caesarean section and eligible for trial of labour. They are at low risk of caesarean section and therefore have all the favourable factors for a vaginal delivery.

The results of the study will encourage :

  • The engagement of all stakeholders involved in the decision-making process for birth
  • The appropriate use of caesarean section in various context
  • Policy-makers to implement non-clinical interventions to reduce unnecessary caesarean sections