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[Perspectives] Ana Pilar Betrán: seeking the optimum use of caesarean section

What is the “correct” rate of deliveries in which birth should be by caesarean section? There is no clear-cut answer to the question, and the success of recommendations intended to raise or lower an existing caesarean section rate is not easily judged by reference to a predetermined numerical goal. As one of the key contributors to this issue’s Lancet Series on optimising the use of caesarean section, Ana Pilar Betrán of WHO’s Department of Reproductive Health and Research finds herself in territory characterised by uncertainty.