To assess the cesarean delivery (
CD) rate among low‐risk pregnancies before and after implementation of a hospital‐based program in Canada. Methods
A prospective before‐and‐after study was conducted to assess the effects of the
CARE( CAesarean REduction) strategy, which was developed and implemented at Markham Stouffville Hospital, Toronto, ON, Canada, in 2010 to reduce CDamong low‐risk women. Hospital records were reviewed to identify changes in the proportions of CDperformed during 12 months (April 2009–March 2010) before implementation of the CAREstrategy versus 12 months after implementation (April 2012–March 2013) at Markham Stouffville Hospital and 36 hospitals of the same level in the same province. Results
At the intervention hospital, 30.3% (964/3181) of women underwent
CDin 2009–2010, compared with 26.4% (803/3045) in 2012–2013 (difference −3.9%, P<0.001). By contrast, no significant difference was recorded in control hospitals (28.1% [23 694/84 361] vs 28.2% [23 683/83 895]; difference 0.1%, P=0.5157). Conclusion
Implementation of the
CAREstrategy reduced rates of CDamong the target population.