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Caesarean section
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===Prevention=== The prevalence of caesarean section is generally agreed to be higher than needed in many countries, and physicians are encouraged to actively lower the rate, as a caesarean rate higher than 10β15% is not associated with reductions in maternal or infant mortality rates,<ref name="WHO2015" /> although some evidence support that a higher rate of 19% may result in better outcomes.<ref name=Mol2015/> Some of these efforts include emphasizing a long [[Childbirth#First stage|latent phase]] of labor is not abnormal and not a justification for C-section; a new definition of the start of active labor from a cervical dilatation of 4 cm to a dilatation of 6 cm; and allowing women who have previously given birth to push for at least 2 hours, with 3 hours of pushing for women who have not previously given birth, before [[Tocolytic|labor arrest]] is considered.<ref name=ACOG2014/> [[Physical exercise]] during pregnancy decreases the risk.<ref>{{cite journal | vauthors = Domenjoz I, Kayser B, Boulvain M | title = Effect of physical activity during pregnancy on mode of delivery | journal = American Journal of Obstetrics and Gynecology | volume = 211 | issue = 4 | pages = 401.e1β401.11 | date = October 2014 | pmid = 24631706 | doi = 10.1016/j.ajog.2014.03.030 }}</ref> Additionally, results from a 2021 systematic review of the evidence on outpatient [[cervical ripening]] found that in women with low-risk pregnancies, the risk of caesarean delivery with harm to the mother or child was not significantly different from when done in an inpatient setting.<ref>{{Cite book | vauthors = McDonagh M, Skelly AC, Hermesch A, Tilden E, Brodt ED, Dana T, Ramirez S, Fu R, Kantner SN, Hsu F, Hart E |url=http://www.ncbi.nlm.nih.gov/books/NBK569292/ |title=Cervical Ripening in the Outpatient Setting |date=2021 |publisher=Agency for Healthcare Research and Quality (US) |series=AHRQ Comparative Effectiveness Reviews |location=Rockville (MD) |pmid=33818996}}</ref>
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