Intended for healthcare professionals


Decision aids for women with a previous caesarean section

BMJ 2007; 334 doi: (Published 21 June 2007) Cite this as: BMJ 2007;334:1281
  1. Jeremy A Lauer, economist1,
  2. Ana P Betrán, technical officer2
  1. 1Health Systems Financing, World Health Organization, 1211 Geneva 27, Switzerland
  2. 2Making Pregnancy Safer, World Health Organization
  1. lauerj{at}

    Focusing on women's preferences improves decision making

    Rates of caesarean section are a cause of concern worldwide, although the problems vary according to the setting. In many poor countries, mostly in Africa, where average rates are 2%, caesarean section is underused because of lack of facilities and trained personnel.1 In other developing countries such as ones in Latin America and eastern Asia, incidence is 30% of all births or higher, even though large sections of the population lack access to basic obstetric care, while in developed countries it has steadily risen to about 20–25%.1 Despite such big differences between countries, the modifiable causes of rising caesarean section rates and what to do about them are unclear.

    In this week's BMJ, a randomised controlled trial by Montgomery and colleagues looks at the effect of two computer based decision aids compared with usual care in pregnant women who have had a previous caesarean section.2 One aid provided structured information about possible …

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