Introduction

Developing countries, as other regions of the world, are faced to the challenge of making the best use possible of limited resources to improve the health of women and children. Obstetrical interventions should be evidence-based, and interventions effective only in high-risk groups should not be used routinely. Morbidity and mortality caused by unnecessary interventions could be a significant problem, and a world-wide epidemic of obstetrical interventions could have a serious negative health impact. However, it is unclear if such a world-wide epidemic exists, because studies have generally been focused on one country or region. Our objective is to review available data on the frequency of obstetrical interventions in all regions of the developing world. We will focus this review on three interventions: cesarean sections, episiotomies, and oxytocics. We will also discuss potential strategies to decrease the use of unnecessary interventions.