Achievement of health sector evolution objectives in the vaginal delivery promotion plan: A study in a large public hospital in Tehran

Promoting normal vaginal delivery and, consequently, reduction in cesarean section rate is one of the health sector evolution goals. This study was aimed to determine health sector evolution plan’s achievement in vaginal delivery promotion in a large public hospital in Tehran.
Material and This cross-sectional study was conducted in 2015. Data were assembled from the hospital information system and the number of cesarean and vaginal deliveries in 2013 and 2014 for all obstetricians of the study hospital was separately entered in Excel (version 2013). Data regarding patientsatisfaction and vaginal delivery bills was extracted from the patient records and hospital documents.
Among totally 5 obstetricians of the hospital, four doctors have reduced their cesarean rate between 3 to 7 percent compared the baseline year. However, all of the obstetricians failed in their attempt to achieve the 10 percent reduction in cesarean rate as the objective of vaginal delivery promotion plan at the end of study period compared to the baseline year. The hospital had totally only 2 percent reduction in the cesarean rate. Furthermore, patients, satisfaction was increased about 1.9 percent compared to the baseline and all bills of vaginal delivery was free of charge.
It seems that factors such as being as a teaching hospital and referring complicated deliveries to this referral hospital, have led to the unsuccessfulness of this hospital in achieving the objectives of vaginal delivery promotion plan as 10 percent reduction in the rate of cesarean section.