Improving Safe Vaginal Deliveries for Delivering Mothers by Implementing an Intervention Package of 11 Evidence-based Practices and Robson Classification at a Semi-urban Hospital in Dhaka, Bangladesh

NCT07461571 | Completed

• 1 other identifier: CWCH/ERC/2017/010
• Study Type: interventional
• Target: 2,475
• Locations: 1 country
• Sites: 1

Brief Summary

The objective of this study was to assess whether a package of 11 evidence-based maternity practices, combined with routine monitoring and Robson Classification, could reduce C-section rates in a semi-urban hospital in Dhaka, Bangladesh. Our intervention targeted the key drivers of unnecessary caesarean section at CWCH: weak labour monitoring, low use of evidence-based induction/vaginal birth after caesarean (VBAC) criteria, limited consultant oversight of C-section indications, and insufficient antenatal counselling.

Conditions

Caesarean Section

Keywords

caesarean section; Robson classification; normal vaginal delivery; VBAC; reproduction; maternal health; Bangladesh

Outcome Measures

Primary Outcomes (1)

• Caesarean section rate

  Proportion of caesarean sections among total deliveries

  70 weeks

Secondary Outcomes (4)

• Absolute and non-absolute indications for caesarean sections

  70 weeks

• Robson classification for all deliveries

  70 weeks

• Absolute CS rate by Robson Classification

  70 weeks

• Relative CS rate by Robson Classification

  70 weeks

Study Arms (2)

Pre-intervention Baseline Phase

NO INTERVENTION

Participants recruited before implementation of the intervention to compare against participants that will receive the intervention

Post-intervention Endline Phase

ACTIVE COMPARATOR

Participants recruited after implementation of the intervention to compare against participants that did not receive the intervention

Other: Package of 11 evidence-based maternity practices combined with Robson TGCS Classification

Interventions

Package of 11 evidence-based maternity practices combined with Robson TGCS Classification OTHER

The intervention package comprised 11 evidence-based maternity practices designed to reduce unnecessary C-sections and promote safe vaginal deliveries: 1. ANC counselling for expecting mothers. 2. Waiting up to 41 weeks of gestation for spontaneous onset of labour. 3. Risk screening for NVD and induction of labour at term. 4. Assessment of Bishop Score on admission. 5. Supportive care during labour and delivery. 6. Continuous monitoring with CTG. 7. Use of partograph 8. Induction or augmentation of labour as indicated, using prostaglandin or oxytocin for induction, based on Bishop Score. 9. Consultant review of CS indications during ward rounds. 10. Vaginal birth after caesarean (VBAC) for selected cases with appropriate monitoring. 11. Immediate care of the newborn. Additionally, all deliveries were classified using the Robson Ten Group Classification System.

Post-intervention Endline Phase

Eligibility Criteria

• Gender Eligibility Details: Cisgender women
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• \- Admitted into the maternity and labour ward of AWCH for delivery.

You may not qualify if:

• Unable to provide consent
• Age is less than 18 years
• Refused to participate in the study

Sponsors & Collaborators

• Ashulia Women and Children Hospital: lead

Study Sites (1)

Ashulia Women and Children Hospital

Dhaka, Dhaka Division, 1349, Bangladesh

Location

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NON RANDOMIZED
• Masking: DOUBLE
• Who Masked: INVESTIGATOR, OUTCOMES ASSESSOR
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: SEQUENTIAL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor, Department of OBGYN

Study Record Dates

• First Submitted: March 3, 2026
• First Posted: March 10, 2026
• Study Start: June 1, 2017
• Primary Completion: February 10, 2019
• Study Completion: August 18, 2019
• Last Updated: March 12, 2026

Record last verified: 2026-03

Data Sharing

• IPD Sharing: Will not share

Locations

BA (1)