Pinto P, Crispín-Milart PH, Rojo E, et al. - In this study, researchers examined how the introduction of an internal clinical audit affects the cesarean section (CS) rate, evaluated according to the Robson Ten Group Classification System (TGCS). Further, they investigated the main contributors to the overall CS rate in order to plan further interventions. In 2014, an internal clinic audit committee was established and modifications of clinical management protocols were implemented at their center. They conducted a retrospective review of clinical records and compared preaudit (2011-2014) results against audit (2015-2018) results. From January 2011 to December 2018, they identified 12,766 women gave birth at their institution; of these, 2,281 CS were analyzed. The establishment of the clinical audit was correlated with reduction in the overall CS rate from 20.27% to 14.82%. TGCS appears to be the most relevant classification to compare CS rates at present as it aided in identification of groups exhibiting the greatest impact on CS rate in order to establish new strategies that may allow optimization of the use of this intervention. Per observations, they emphasize to direct the efforts to reduce the overall CS rate on enhancing vaginal birth after CS and reducing CS rates in nulliparous women with single cephalic full-term pregnancy.