Strengths and Limitations
Strengths of our study include large sample size and the depth of
chart-abstracted clinical data allowing us to explore indications for
pre-labor cesarean as well as the rates within Robson groups. Although
our data are derived from a diverse group of hospitals, it is unknown
whether our findings are generalizable to other populations in the US.
Data abstracted from medical records resulted in few non-classifiable
births (0.5%) in the Robson classification. Additionally, Group 9 was
appropriate in size and associated with a high cesarean birth rate,
findings highlighted by Robson as indicators of the quality and
completeness of cesarean birth datasets.12 Chart
abstracted data also gave us greater insight into why these surgeries
were performed.