A cesarean section can be a life-saving procedure for a woman with a complicated pregnancy – but in some countries, too many women deliver by c-section, even when it isn’t necessary. In other countries, women can’t get a c-section when they need it.

Why does this huge difference persist?

On this episode of The Dose, Pierre Barker, who heads global partnerships at the Institute for Healthcare Improvement, explains why some countries have a much higher c-section rate than others. Pierre and his colleagues use a method called quality improvement to change the approach taken by health care systems around the world when it comes to c-sections.