Plan–Do–Check–Act Method to Reduce Cesarean Section Deliveries at a Tertiary Hospital: A Teaching Case Study

According to the World Health Organization (WHO), cesarean section (C-Section) rates >10–15 is not justifiable in any setting. However, the number of C-sections performed has steadily increased in both affluent and low- and middle-income nations in the past three decades. About 21% increase in the number of C-sections was observed from the National Family Health Surveys 4 to 5 in India. Studies have clearly shown a disparity in C-section rates between rural–urban, private–public health institutions, and high–low educated women. The present teaching case study details of quality improvement project using plan–do–check–act (PDCA) for reducing C-section in a tertiary care hospital. The case study highlights the implementation of PDCA cycle using team approach, capacity building, standardizing of clinical protocols, audit, and addressing nonclinical factors associated with C-section. Proven methods for path to change for improvement from the literature are used for designing of PDCA cycle. Hospitals planning to reduce elective C-section deliveries can adopt and adapt the plans and methods described in this teaching case study.