What do systematic reviews say?

Summary of findings table ‐ Planned hospital birth vs Planned home birth

• Planned hospital birth compared with planned home birth for pregnant women at low risk of complications 2023 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 11 participants
  Very low

Labour induction vs expectant management

Induction of labour showed no clear difference in caesarean section compared with expectant management (moderate certainty).

• Induction of labour at or near term for suspected fetal macrosomia 2023 · Cochrane Headline outcomes only
  RR 0.91 [0.76, 1.09]
  4 studies · 1190 participants
  Moderate

Balloon (Foley or ATAD) vs low‐dose vaginal misoprostol

Balloon (Foley or ATAD) may leads to higher caesarean section compared with low‐dose vaginal misoprostol (low certainty).

• Mechanical methods for induction of labour 2023 · Cochrane Headline outcomes only
  RR 1.28 [1.02, 1.6]
  12 studies · 1756 participants
  Low

Balloon (Foley or ATAD) vs low‐dose oral misoprostol

Balloon (Foley or ATAD) probably leads to higher caesarean section compared with low‐dose oral misoprostol (moderate certainty).

• Mechanical methods for induction of labour 2023 · Cochrane Headline outcomes only
  RR 1.17 [1.04, 1.32]
  7 studies · 3178 participants
  Moderate

Balloon (Foley or ATAD) vs vaginal prostaglandin E2

Balloon (Foley or ATAD) showed no clear difference in caesarean section compared with vaginal prostaglandin E2 (moderate certainty).

• Mechanical methods for induction of labour 2023 · Cochrane Headline outcomes only
  RR 1 [0.92, 1.09]
  28 studies · 6619 participants
  Moderate

Summary of findings table ‐ Moxibustion plus usual care vs sham moxibustion plus usual care

Summary of findings table ‐ Moxibustion plus usual care showed no clear difference in caesarean section compared with sham moxibustion plus usual care (moderate certainty).

• Cephalic version by moxibustion for breech presentation 2023 · Cochrane Headline outcomes only
  RR 0.84 [0.68, 1.04]
  1 study · 272 participants
  Moderate

Summary of findings table ‐ Moxibustion plus usual care vs usual care

Summary of findings table ‐ Moxibustion plus usual care showed no clear difference in caesarean section compared with usual care (moderate certainty).

• Cephalic version by moxibustion for breech presentation 2023 · Cochrane Headline outcomes only
  RR 0.94 [0.83, 1.05]
  6 studies · 1030 participants
  Moderate

Intervention not reported

The intervention showed no clear difference in caesarean section (low certainty).

• Antenatal dietary supplementation with myo‐inositol for preventing gestational diabetes 2023 · Cochrane Headline outcomes only
  RR 0.91 [0.77, 1.07]
  4 studies · 829 participants
  Low

Intensity of glycaemic control for women with gestational diabetes mellitus ‐ strict glycaemic targets vs less‐tight glycaemic targets (maternal outcomes)

• Different intensities of glycaemic control for women with gestational diabetes mellitus 2023 · Cochrane Headline outcomes only
  0.98 [0.82, 1.17]
  3 studies · 1662 participants
  Moderate

Lateral postures vs other postures

Lateral postures showed no clear difference in caesarean section compared with other postures (low certainty).

• Maternal postures for fetal malposition in labour for improving the health of mothers and their infants 2022 · Cochrane Headline outcomes only
  RR 0.78 [0.44, 1.39]
  4 studies · 871 participants
  Low

Hands and knees posture vs other postures

Hands and knees posture showed no clear difference in caesarean section compared with other postures (low certainty).

• Maternal postures for fetal malposition in labour for improving the health of mothers and their infants 2022 · Cochrane Headline outcomes only
  RR 1.34 [0.96, 1.87]
  3 studies · 721 participants
  Low

Probiotics vs placebo

Probiotics showed no clear difference in caesarean section compared with placebo (high certainty).

• Probiotics for preventing gestational diabetes 2021 · Cochrane Headline outcomes only
  RR 1 [0.86, 1.17]
  6 studies · 1520 participants
  High

Non‐pharmacological interventions for fear of childbirth (tocophobia) vs usual care

Non‐pharmacological interventions for fear of childbirth (tocophobia) probably leads to lower caesarean section compared with usual care (moderate certainty).

• Interventions for fear of childbirth including tocophobia 2021 · Cochrane Headline outcomes only
  RR 0.7 [0.55, 0.89]
  5 studies · 557 participants
  Moderate

Oral misoprostol vs vaginal misoprostol

Oral misoprostol showed no clear difference in caesarean section compared with vaginal misoprostol (low certainty).

• Low‐dose oral misoprostol for induction of labour 2021 · Cochrane Headline outcomes only
  RR 1 [0.86, 1.16]
  32 studies · 5914 participants
  Low

Oral misoprostol vs placebo/no treatment

Oral misoprostol showed no clear difference in caesarean section compared with placebo/no treatment (low certainty).

• Low‐dose oral misoprostol for induction of labour 2021 · Cochrane Headline outcomes only
  RR 0.81 [0.59, 1.11]
  4 studies · 594 participants
  Low

Oral misoprostol vs intravenous (IV) oxytocin

Oral misoprostol probably leads to lower caesarean section compared with intravenous oxytocin (moderate certainty).

• Low‐dose oral misoprostol for induction of labour 2021 · Cochrane Headline outcomes only
  RR 0.67 [0.5, 0.9]
  6 studies · 737 participants
  Moderate

Oral misoprostol vs mechanical methods

Oral misoprostol may leads to lower caesarean section compared with mechanical methods (low certainty).

• Low‐dose oral misoprostol for induction of labour 2021 · Cochrane Headline outcomes only
  RR 0.84 [0.75, 0.95]
  6 studies · 2993 participants
  Low

Oral misoprostol one‐ to two‐hourly vs oral misoprostol four‐ to six‐hourly

It is very uncertain whether oral misoprostol one‐ to two‐hourly changes caesarean section compared with oral misoprostol four‐ to six‐hourly (very low certainty).

• Low‐dose oral misoprostol for induction of labour 2021 · Cochrane Headline outcomes only
  RR 1.31 [0.77, 2.22]
  1 study · 64 participants
  Very low

Oral misoprostol 20 µg hourly titrated vs oral misoprostol 25 µg two‐hourly static

It is very uncertain whether oral misoprostol 20 µg hourly titrated changes caesarean section compared with oral misoprostol 25 µg two‐hourly static (very low certainty).

• Low‐dose oral misoprostol for induction of labour 2021 · Cochrane Headline outcomes only
  RR 1.66 [0.63, 4.32]
  2 studies · 296 participants
  Very low

Oral misoprostol vs vaginal dinoprostone

Oral misoprostol probably leads to lower caesarean section compared with vaginal dinoprostone (moderate certainty).

• Low‐dose oral misoprostol for induction of labour 2021 · Cochrane Headline outcomes only
  RR 0.84 [0.78, 0.9]
  13 studies · 9676 participants
  Moderate