At the facilities, it is essential to monitor the rates of cesarean sections taking into account the specific characteristics of the populations that they serve (obstetrical case mix). Currently, there is no standard classification system for cesarean section that would allow the comparison of caesarean section rates across different facilities, cities, countries or regions in a useful and action-oriented manner. As such, it is not yet possible to exchange information in a meaningful, targeted, and transparent manner to efficiently monitor maternal and perinatal outcomes.
In 2011, WHO conducted a systematic review of systems used to classify cesarean section, and
concluded that the Robson classification is the most appropriate system to fulfill current international and local needs. WHO recommended building upon this to develop an internationally applicable cesarean section classification system.
In 2011, WHO conducted a systematic review of systems used to classify cesarean section, and
concluded that the Robson classification is the most appropriate system to fulfill current international and local needs. WHO recommended building upon this to develop an internationally applicable cesarean section classification system.
The system classifies all women into one of 10 categories that are mutually exclusive and, as a set, totally comprehensive (see Box 1). The categories are based on five basic obstetric characteristics that are routinely collected in all maternities: ƒ parity (nulliparous, multiparous with and without
previous cesarean section); ƒ onset of labour (spontaneous, induced or per-labour cesarean section); gestational age (preterm or term); ƒ foetal presentation (cephalic, breech or transverse); and ƒ number of foetuses (single or multiple). The classification is simple, robust, reproducible,
clinically relevant, and prospective – which means that every woman admitted for delivery can be
immediately classified into one of the 10 groups based on these few basic characteristics. This allows
a comparison and analysis of cesarean section rates within and across these groups.
previous cesarean section); ƒ onset of labour (spontaneous, induced or per-labour cesarean section); gestational age (preterm or term); ƒ foetal presentation (cephalic, breech or transverse); and ƒ number of foetuses (single or multiple). The classification is simple, robust, reproducible,
clinically relevant, and prospective – which means that every woman admitted for delivery can be
immediately classified into one of the 10 groups based on these few basic characteristics. This allows
a comparison and analysis of cesarean section rates within and across these groups.
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