After the global cesarean delivery rate nearly doubled between 2000 and 2015, cesarean deliveries now account for nearly one third of births in the United States. Although rates have plateaued, the high national cesarean delivery rate has garnered criticism from both lay and academic communities because it has not been associated with improvements in maternal or neonatal outcomes. Efforts are underway to lower the cesarean delivery rate through implementation of hospital-level and national guidelines. However, the cesarean delivery rate that optimizes maternal and neonatal outcomes is not known. Defining a cesarean delivery rate that optimizes perinatal outcomes and reduces morbidity seems simple. However, there are a host of challenges to such a task, including determining the outcomes that are most meaningful to use, deciding the population that should define the rate, and incorporating person-centered decision making, given that people place different value on different outcomes. Rather than a “call” for cesarean delivery rate reductions of a specific and arbitrary magnitude, we need further attention to defining an evidence-based optimal target. This commentary summarizes current national and international cesarean delivery rate targets, discusses the challenges of identifying an evidence-based national cesarean delivery rate target, and explores future considerations for best defining a cesarean delivery rate target.

在 2000 年至 2015 年全球剖宫产率几乎翻了一番之后，剖宫产现在占美国分娩的近三分之一。尽管剖宫产率已趋于平稳，但全国剖宫产率高已引起非专业人士和学术界的批评，因为它与孕产妇或新生儿结局的改善无关。正在努力通过实施医院级和国家指南来降低剖宫产率。然而，优化产妇和新生儿结局的剖宫产率尚不清楚。定义优化围产期结果并降低发病率的剖宫产率似乎很简单。然而，这样的任务存在许多挑战，包括确定最有意义的使用结果，考虑到人们对不同的结果赋予不同的价值，决定应该定义比率的人口，并纳入以人为本的决策。我们需要进一步关注确定基于证据的最佳目标，而不是“呼吁”具体和任意幅度地降低剖宫产率。这篇评论总结了当前的国家和国际剖宫产率目标，讨论了确定基于证据的国家剖宫产率目标的挑战，并探讨了未来为最好地定义剖宫产率目标而考虑的因素。我们需要进一步关注确定基于证据的最佳目标。这篇评论总结了当前的国家和国际剖宫产率目标，讨论了确定基于证据的国家剖宫产率目标的挑战，并探讨了未来为最好地定义剖宫产率目标而考虑的因素。我们需要进一步关注确定基于证据的最佳目标。这篇评论总结了当前的国家和国际剖宫产率目标，讨论了确定基于证据的国家剖宫产率目标的挑战，并探讨了未来最佳定义剖宫产率目标的考虑因素。