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To the Editor: The study by Dr Molina and colleagues1 on the relationship between cesarean delivery rate and maternal and neonatal mortality fills a gap in knowledge at the population level. However, the authors misrepresented the position of the World Health Organization (WHO). They stated that WHO “recommended that national rates not exceed 10 to 15 cesarean deliveries per 100 live births.” However, the WHO position statement on cesarean delivery published in April 2015 explicitly eschews any target rate: “Every effort should be made to provide caesarean sections to women in need, rather than striving to achieve a specific rate.”2
Uzoigwe C, Franco LCS, Conde IG. Maternal and Neonatal Mortality After Cesarean Delivery. JAMA. 2016;315(18):2016-2017. doi:10.1001/jama.2016.0924