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Nigel, We have not published any of our guidelines, they are used here mainly as 'agents of change'. In developing our guidelines we use the methods originally described by 'The Canadian Taskforce on the Periodic Health Examination' but described locally in the NH&MRC (1995a) Guidelines for the Development and Implementation of Clinical Practice Guidelines. Quality of Care and Health Outcomes Committee, National Health & Medical Research Council. Canberra: Australian Government Printing Service, and elsewhere. As to our C/S rates, I can only agree with you that they are too high. Currently a Materninty Services Review is being conducted at out hospital and I know that C-section rates are included in the Review's scope. Joan Webster Director of Nursing - Research & Development Royal Women's Hospital & Health Service District Bowen Bridge Road Herston 4029 Australia Ph +61 (0) 7 3253 8590 Fax +61 (0) 7 3253 1472 email: [log in to unmask] %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%