J Anesth Perioper Med. 2017;4(3):139-143. https://doi.org/10.24015/ebcmed.japm.2017.0031

Safe Prevention of Primary Cesarean Section in China

Susan Hellerstein

From the Department of Obstetrics and Gynecology, Brigham and Women’s Hospital, Harvard Medical School, Boston, USA.

Correspondence to Dr. Susan Hellerstein at shellerstein@partners.org.

EBCMED ID: ebcmed.japm.2017.0031 DOI: 10.24015/ebcmed.japm.2017.0031


In summary, although China and the USA have similar total CD rates, the safe prevention of the primary cesarean section in China differs from the USA efforts due the differences in indications for primary CD. With the combination of the prior high percentage of elective primary CD and the new Two Child Policy in China there is unique opportunity that may make it easier to significantly decrease the primary cesarean rate in China than in the USA. Decreasing CD rates in some of China’ s supercities are promising. Further clarification of obstetric management guidelines for abnormal or indeterminate FHRT, labor dystocia, malpresentation, and suspected fetal macrosomia may allow further decrease in China’ s primary CD rate. However there will be a lag before efforts to reduce the primary CD rate will be reflected in a reduction in the overall CD due to a concomitant increase in the repeat CD rate as more women in China, many older and with a prior CD, have a second child.

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Declaration of Interests
The author declares no conflicts of interest.

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