Midwifery models of care in the context of increasing caesarean delivery rates

Abstract

Clinicians and researchers have used the concepts of too little too late, and too much too soon for almost a decade to describe disparities in access to and levels of use of clinical procedures in maternity care worldwide.1 The case of caesarean delivery is the most widely debated of these procedures. In many countries, rates are below safe levels in particular geographies or population groups, indicating that mothers and babies may be experiencing adverse outcomes due to a lack of access to the operation. On the other hand, the World Health Organization (WHO) has stated that, while low caesarean delivery rates indicate poor coverage of essential maternity care, no public health benefit exists when the rate exceeds 10–15% at a population level.