Changes in cesarean section rates after introduction of a punitive financial policy in Georgia: A population-based registry study 2017-2019.

The cesarean section rate in Georgia decreased during the 2-year post-policy period. The reduction mainly took place among primiparous women. The policy had no impact on the neonatal intensive care unit transfer rate or the perinatal mortality rate. The impact of the national cesarean section reduction policy on other outcomes is not known.