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Results: Among totally 5 obstetricians of the hospital, four doctors have reduced their cesarean rate between 3 to 7 percent compared the baseline year. However, all of the obstetricians failed in their attempt to achieve the 10 percent reduction in cesarean rate as the objective of vaginal delivery promotion plan at the end of study period compared to the baseline year. The hospital had totally only 2 percent reduction in the cesarean rate. Furthermore, patients, satisfaction was increased about 1.9 percent compared to the baseline and all bills of vaginal delivery was free of charge.

Conclusion: It seems that factors such as being as a teaching hospital and referring complicated deliveries to this referral hospital, have led to the unsuccessfulness of this hospital in achieving the objectives of vaginal delivery promotion plan as 10 percent reduction in the rate of cesarean section.