(Abstracted from Lancet 2019;393(10184):1973–1982)
Around the world every year, 300,000 women die during childbirth, with 99% of these cases occurring in low- and middle-income countries (LMICs). One potential cause is accessibility to cesarean deliveries in these countries, which are both overutilized and underutilized and contribute to maternal and perinatal adverse outcomes.
Barts Research Centre for Women's Health (S.S., N.M., K.K., J.Z., S.T.), Multidisciplinary Evidence Synthesis Hub (S.S., K.K., J.Z., S.T.), Barts and the London School of Medicine and Dentistry (S.S., K.K., J.Z., S.T.), WHO Collaborating Centre for Women's Health (S.S., K.K., J.Z., S.T.), Queen Mary University of London, London, United Kingdom; Clinical Biostatistics Unit, Hospital Ramon y Cajal (IRYCIS), Madrid, Spain (D.A.-M., J.Z.); Department of Obstetrics and Gynaecology, Madurai Medical College, Madurai (G.K.); Department of Surgery, Tirunelveli Medical College, Tirunelveli (V.K.); Department of Obstetrics and Gynaecology, Fernandez Hospitals, Hyderabad (I.K., E.F., S.R.G.), India; UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development, and Research Training in Human Reproduction, Department of Reproductive Health and Research, WHO, Geneva, Switzerland (A.P.B.); and CIBER Epidemiology and Public Health, Madrid, Spain (J.Z.)