Highlight
– Implementation of a structured, multidisciplinary caesarean section (CS) reduction strategy resulted in a significant and sustained decrease in CS rates from 2016 onward.
– Vaginal birth after caesarean (VBAC) rates increased significantly over time without an associated rise in uterine rupture.
– Maternal morbidity remained largely stable, though a slight rise in postpartum hemorrhage was noted.
– Neonatal outcomes, including severe acidosis and resuscitation needs, remained unchanged despite decreased CS rates.
