Objective To explore the application effects of different surgical techniques in cesarean section for placenta previa，with consideration of varying fertility policies. Methods To explore the application effects of different surgical methods in cesarean section for placenta previa，with consideration of changes in fertility policies. MethodsA retrospective analysis was conducted on 237 pregnant women with placenta previa who underwent cesarean section in the Obstetric Department of our hospital from January 1，2003 to December 31，2022. Based on the time of changes in fertility policies，they were divided into three groups： Group A （before the two-child policy， from January 1，2003 to December 31，2015），Group B （after the two-child policy， from January 1，2016 to December 31，2019），and Group C （after the three-child policy， from January 1，2020 to December 31，2022）. During this period，the main surgical approaches for managing placenta previa in our department included hysterectomy，ligation of the ascending uterine artery branches intraoperatively and placement of an intrauterine hemostatic balloon，and cervical suture ligation. We analyzed and compared the hysterectomy rates，length of hospital stay，surgical duration，intraoperative blood loss，perioperative transfusion rates，perioperative infection rates，and perioperative ICU transfer rates among the three time periods. Results Comparison among the three groups showed that the hysterectomy rates were 31.6%，16.7%，and 11.3%，respectively； the lengths of hospital stay were 12.72 days，8.80 days，and 10.11 days，respectively； there were statistically significant differences （all P<0.05）. There were no statistically significant differences in surgical duration，intraoperative blood loss，perioperative transfusion rates，perioperative infection rates，or perioperative ICU transfer rates among the three groups. Conclusion With changes in fertility policies，comprehensive treatment for placenta previa，especially improvements in surgical methods，has contributed to reducing hysterectomy rates and shortening the length of maternal hospital stay.