DECREASED CESAREAN BIRTH-RATES AND IMPROVED PERINATAL OUTCOME - A 7-YEAR STUDY

This study examined the decrease in cesarean section rates in relation to perinatal mortality bent een 1987 and 1993 at the primary referral hospital in north Jordan. Most of the population is at high risk and of low socioeconomic status. The cesarean section rate decreased from 15.5 percent in 1987 to 8.7 percent in 1993, and has remained at this low rate. During the same period the perinatal mortality dropped from 52 to 20.9 deaths per 1000 live births. These results do not include p erinatal morbidity. The successful reduction of the cesarean section r ate is attributed to active management of label; trial of labor for wo men with a previous cesarean birth, and vaginal breech delivery in sel ected women. We conclude that the rate of cesarean delivery can be saf ely reduced in a developing country without adverse effects on birth o utcomes.