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Objective: To evaluate the efficiency of the Robson classification as an internal clinical audit and feedback of the high rate of cesarean delivery at Hotel Dieu de France, a tertiary referral hospital. Methods: A pre‐post study was conducted, with a retrospective approach in 2018 and 2019, identified as the pre‐period (before the implementation of the Robson classification), and with a prospective approach in 2020 and 2021, labeled the post‐period. Results: The total number of deliveries during the study period was 2560; 1305 patients were included in the pre‐period and 1255 patients delivered in the post‐period. No significant differences between the two groups were found. No significant difference was found in the overall rate of cesarean delivery between the first and second periods (57.86% vs 56.72%; P = 0.2). However, a significant decrease in the absolute contribution of groups 3 and 4 (multiparous women without a previous uterine scar with a single cephalic pregnancy, ≥37 weeks of gestation, with spontaneous labor or induced labor) in the overall rate of cesarean delivery was remarked (P = 0.02 and 0.01, respectively). Conclusion: The Robson classification seems to be appropriate to monitor and audit the rate of cesarean delivery, but not sufficient to decrease the rate and change the practice. Synopsis: The adoption of the Robson classification as an internal audit and feedback does not reduce the rate of cesarean delivery but may be helpful in the analysis. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the cesarean section rate using the Robson Classification for the first time in Lebanon, at Hôtel‐Dieu de France University Hospital, a tertiary referral center in Beirut. Methods: Routine medical record data that included all live births from January 1, 2018 to September 30, 2020 was investigated. The overall cesarean section rate was recorded, and the size, cesarean section rate, and absolute and relative contributions were calculated within each group. Results: The overall cesarean section rate was 56.8%. The highest relative contribution to this rate came from Robson groups 5, 2 and 10, respectively. A decrease in cesarean section rate was noted in 2020 among women admitted for induction of labor (groups 2 and 4) following the implementation of new department policies and the restrictions caused by the coronavirus disease 2019 pandemic. Conclusion: More than 50% of the deliveries in our department were by cesarean sections (CS). Strategies to reduce this rate should include stricter departmental policies for avoidance of unindicated primary CS and raising practitioners' and patients' awareness about trial of labor after cesarean section. The application of the Robson Classification for the first time in Lebanon is helpful in analyzing and decreasing the high cesarean section rate. [ABSTRACT FROM AUTHOR]