Hanoi, Vietnam – A doctoral project at the Karolinska Institutet is shedding light on the complex interplay of cultural beliefs and clinical practices surrounding childbirth in Vietnam, a country presenting a striking paradox: high rates of Cesarean sections alongside remarkably low reported newborn complications. The research, led by Toàn Khac Nguyen, aims to unravel the reasons behind this unusual combination and identify potential areas for improvement in obstetric care.
Nguyen’s project, titled “Obstetric Care Challenges: Experience from Two Large Obstetric Hospitals in Vietnam and Sweden,” focuses on Phu San Hanoi Hospital, where over half of all deliveries are performed via C-section, yet only 0.61% of newborns require immediate breathing support – a figure significantly lower than the global average of 3% to 10%. This discrepancy has prompted Nguyen to investigate whether medical interventions are effectively preventing complications, or if factors such as incomplete recording or deeply ingrained cultural influences are at play. The research is particularly timely as healthcare systems worldwide grapple with optimizing maternal and newborn health outcomes.
Exploring Cultural Influences on Birth Scheduling
A key component of Nguyen’s research examines how cultural beliefs impact birth scheduling. Specifically, the practice of choosing “auspicious” birth dates based on the lunar calendar is being investigated for its potential influence on the timing of deliveries. Preliminary findings suggest that fewer babies are born on days considered “inauspicious” compared to other days, indicating a deliberate effort to align births with culturally preferred dates. This practice raises questions about the extent to which medical necessity dictates delivery timing versus cultural preferences.
The project as well delves into the impact of high Cesarean rates on newborn outcomes, the dynamics of workplace culture and organizational pressures on clinical decision-making, and a comparative analysis of Vietnam’s doctor-led obstetric model with Sweden’s midwife-led system. This multifaceted approach seeks to identify best practices and potential areas for improvement in patient safety and overall obstetric care.
Successful Half-Time Review Signals Progress
On March 12, 2026, Toàn Khac Nguyen successfully completed his half-time review at the Karolinska Institutet, a significant milestone in his doctoral journey. The review committee included a diverse group of experts from both Vietnam and Sweden, demonstrating the international collaboration underpinning this important research. Members of the committee included Associate Professor Lê Thị Anh Đào of Hanoi Medical University, Vietnam; Associate Professor Donghao Lu of the Institute of Environmental Medicine (IMM) at Karolinska Institutet; and Professor Pauliina Damdimopoulou of the Department of Women’s and Children’s Health (KBH) at Karolinska Institutet.
Nguyen’s main supervisor is Susanna Myrnerts Höök, PhD, from the Department of Global Public Health at Karolinska Institutet. He also benefits from the guidance of co-supervisors including Professor Tobias Alfvén, Dr. Nicolas Pejovic, and Professor Olof Stephansson, all from Karolinska Institutet, as well as Professor Anh Duy Nguyen from the Department of Obstetrics and Gynecology at Hanoi National University, Vietnam, and Dr. Linus Olson from the Department of Women’s and Children’s Health at Karolinska Institutet. Karolinska Institutet News highlighted the successful completion of this review.
Implications for Global Maternal Health
The findings from Nguyen’s research have the potential to inform obstetric practices not only in Vietnam but also in other countries facing similar challenges. Understanding the interplay between cultural beliefs, clinical decision-making, and healthcare systems is crucial for optimizing maternal and newborn health outcomes globally. The project’s comparative analysis of doctor-led and midwife-led models could offer valuable insights into alternative approaches to obstetric care. Toàn Khac Nguyen’s profile at the Karolinska Institutet details his ongoing operate.
As Nguyen continues his research, the focus will likely turn to analyzing data collected from both Vietnamese and Swedish hospitals, further refining the understanding of the factors contributing to the observed differences in obstetric practices, and outcomes. The next phase of the project will involve a deeper exploration of the organizational and cultural factors influencing clinical decision-making, with the ultimate goal of identifying strategies to improve patient safety and enhance the quality of obstetric care.
This research underscores the importance of culturally sensitive approaches to healthcare and the need for ongoing investigation into the complex factors shaping maternal and newborn health.
Disclaimer: This article provides informational content and should not be considered medical advice. Please consult with a qualified healthcare professional for any health concerns or before making any decisions related to your health or treatment.
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