in the United States in 1965 was 4.5 percent (Placek, Taffel, and Moien 562-564). The rate of cesarean section deliveries in the United States in 1993 was 24.8 percent (Taffel, Clarke, Placek, Parrish, Holt, Connell, and Easterling 1829-1830). Comparisons of these data support the contention that a significant proportion of cesarean section deliveries represent an abuse of the surgical procedure.
The use of the cesarean section procedure does lead to improved outcomes for some complications of pregnancy, however, negative consequences are also associated with delivery by cesarean section (Fawcett, Tulman, and Spedden 253-259). Because of these anomalies, both some physicians and some women have concluded that cesarean sections generally occur in too many cases (Stafford 59-63). Flowing from this skepticism has been an increase in vaginal deliveries for women who previously had delivered through low-section cesareans, although the overall rate of cesarean section procedures has not dropped (Rates 2360). The rate of vaginal delivery following a prior cesarean delivery (referred to as VBAC or vaginal birth after cesarean), however, increased from 3.4 percent in 1980 to 18.5 percent in 1989.Clinical factors are important considerations in some decisions to use cesarean section (Taffel, et al. 1829-1830). Clinical factors, however, do not appear to be the governing criteria in most such decisions (Faiola 2338-2339). One such nonclinical factor is the medical malpractice laws in the United States. Many physicians,
...