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caesarean section plays an important role in ensuring safety of mother and infant but rising rates are not accompanied by measurable improvements in maternal or neonatal mortality or morbidity. The ‘Focus on Normal Birth and Reducing Caesarean section Rates Rapid Improvement Programme’ was a facilitative initiative developed to promote opportunities for normal birth and reduce caesarean section rates in England.

to evaluate the ‘Focus on Normal Birth and Reducing Caesarean section Rates’ programme, by assessment of: impact on caesarean section rates, use of service improvements tools and participants׳ perceptions of factors that sustain or hinder work within participating maternity units.

a mixed methods approach included analysis of mode of birth data, web-based questionnaires and in-depth semi-structured telephone interviews.

twenty Hospital Trusts in …