Over the past two decades, caesarean section rates have been steadily increasing with rates are now approaching 55% in some European countries. While caesarean section remains one of the most critical obstetric interventions, often lifesaving for both mother and newborn, it also carries significant risks for maternal and neonatal health. The growing reliance on caesarean birth is further linked to a marked decline in instrumental births, thereby limiting opportunities for future obstetric trainees to acquire essential clinical skills. This invited review offers evidence-based recommendations aimed at safely reducing the incidence of caesarean sections, without compromising the quality of care provided during childbirth.

Chief Perinatal Centre of the Institute for the Care of Mother and Child 3rd Medical School of Charles University Prague Czech Republic Chief WHO Collaborating Centre in Perinatal Medicine Prague Czech Republic and Chair EBCOG Standing Committee on Training Recognition Leuven Belgium

Department of Obstetrics and Gynaecology Universitätsklinikum Frankfurt Goethe Universität Germany and President EBCOG Leuven Belgium

Obstetrics and Gynaecology Institution for Clinical Sciences Lund Lund University and Skåne university hospital Malmö Sweden and Member EBCOG Standing Committee on Standards of Care and Position Statements Leuven Belgium

University of Malta Malta and Member EBCOG Standing Committee on Standards of Care and Position Statements Leuven Belgium

Visiting Gynaecologist Spire Murrayfield Hospital Edinburgh Scotland United Kingdom Past President EBCOG and Chair EBCOG Standing Committee on Standards of Care and Position Statements Leuven Belgium

Visiting Obstetrician Department of Obstetrics and Gynaecology Erasmus University Medical Centre Rotterdam the Netherlands and Past chair EBCOG Standing Committee on Training Recognition Emeritus Council Member of EBCOG Leuven Belgium

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