The aim of this study was to assess the impact of this policy on cesarean section rates, subgroups of women, and selected perinatal outcomes. The cesarean section rate in Georgia decreased during the 2-year post-policy period. The reduction mainly took place among primiparous women. The policy had no impact on the neonatal intensive care unit transfer rate or the perinatal mortality rate. The impact of the national cesarean section reduction policy on other outcomes is not known.


  1. Betran AP, Ye J, Moller A-B, Souza JP, Zhang J. Trends and projections of caesarean section rates: global and regional estimates. BMJ Glob Health. 2021;6(6):e005671. pmid:34130991

  2. Kozhimannil KB, Graves AJ, Ecklund AM, Shah N, Aggarwal R, Snowden JM. Cesarean Delivery Rates and Costs of Childbirth in a State Medicaid Program After Implementation of a Blended Payment Policy. Med care. 2018;56(8):658–64. pmid:29912840

  3. Yu Y, Zhang X, Sun C, Zhou H, Zhang Q, Chen C. Reducing the rate of cesarean delivery on maternal request through institutional and policy interventions in Wenzhou, China. PLoS One. 2017;12(11):e0186304. pmid:29155824


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