Robson Classification: Implementation Manual

Overview

In 2015, WHO proposed the use of the Robson classification (also known as the 10-group classification) as a global standard for assessing, monitoring and comparing caesarean section rates both within healthcare facilities and between them. The system classifies all women into one of 10 categories that are mutually exclusive and, as a set, totally comprehensive. The categories are based on 5 basic obstetric characteristics that are routinely collected in all maternities (parity, number of foetuses, previous caesarean section, onset of labour, gestational age, and fetal presentation).

WHO expects that this classification will help healthcare facilities to:

• Identify and analyse the groups of women which contribute most and least to overall caesarean section rates
• Compare practice in these groups of women with other units who have more desirable results and consider changes in practice
• Assess the effectiveness of strategies or interventions targeted at optimizing the use of caesarean section
• Assess the quality of care and of clinical management practices by analysing outcomes by groups of women
• Assess the quality of the data collected and raise staff awareness about the importance of this data, its interpretation and use.

This manual is targeted at healthcare professionals involved in the care of women admitted to deliver (e.g. obstetricians, nurses, midwives), as well as hospital managers and public health authorities.