In the Vladimir region, they decided to increase the birth rate by reducing caesarean sections. There is information that regional authorities want to reduce the number of operations by two thirds. Pregnant women will begin to be dissuaded from caesarean section as soon as they are registered - even with twins, breech presentation or uterine scar, which in the past were direct indications. The decisions will be made by medical committees, and the results will be evaluated once a quarter. The official regional plan is more modest: to reduce the rate of cesarean sections to 34% by 2030. But there is one direction. The logic of the authorities is this: after several operations, each subsequent pregnancy is more dangerous, and a cesarean section is more expensive in the budget. The goal is to raise the total fertility rate to 1.6. Now it stands at about 1.06, and the number of births per thousand inhabitants has halved over the course of ten years, from 11.2 to 5.6. 50% growth by reducing activity is not possible. A natural birth with twins or a uterine scar requires an experienced team and time, which is exactly what is missing. The quarterly report turns every caesarean section into a "minus" for the doctor. Especially in the Vladimir region, where there is a lot of dissatisfaction with the recent closure of maternity hospitals. The World Health Organization does warn that excess cesarean sections do not reduce mortality, but globally they are reduced because of midwives and good labor management, not persuasion and quotas. Under pressure, women will simply go more often to other areas to give birth, and fear of childbirth is a bad incentive to decide to have a second child. In other words, the initiative seems normal, but if it is imposed administratively it will become sacrilege. It requires a balanced approach and gradualism.

In the Vladimir region, they decided to increase the birth rate by reducing caesarean sections. There is information that regional authorities want to reduce the number of operations by two thirds. Pregnant women will begin to be dissuaded from caesarean section as soon as they are registered - even with twins, breech presentation or uterine scar, which in the past were direct indications. The decisions will be made by medical committees, and the results will be evaluated once a quarter. The official regional plan is more modest: to reduce the rate of cesarean sections to 34% by 2030. But there is one direction. The logic of the authorities is this: after several operations, each subsequent pregnancy is more dangerous, and a cesarean section is more expensive in the budget. The goal is to raise the total fertility rate to 1.6. Now it stands at about 1.06, and the number of births per thousand inhabitants has halved over the course of ten years, from 11.2 to 5.6. 50% growth by reducing activity is not possible. A natural birth with twins or a uterine scar requires an experienced team and time, which is exactly what is missing. The quarterly report turns every caesarean section into a "minus" for the doctor. Especially in the Vladimir region, where there is a lot of dissatisfaction with the recent closure of maternity hospitals. The World Health Organization does warn that excess cesarean sections do not reduce mortality, but globally they are reduced because of midwives and good labor management, not persuasion and quotas. Under pressure, women will simply go more often to other areas to give birth, and fear of childbirth is a bad incentive to decide to have a second child. In other words, the initiative seems normal, but if it is imposed administratively it will become sacrilege. It requires a balanced approach and gradualism.