The Cesarean epidemic: Are we too quick to cut?: Cesarean delivery may be a safe alternative to vaginal delivery but its use in 1 of 3 women giving birth in the US seems too high

Although cesarean delivery may be a safe alternative to attempting vaginal delivery, its use in 1 in 3 women giving birth appears to be too high. Further, the effect of cesarean delivery on future pregnancies is likely not well considered when the first cesarean is being performed. Practices that have become standard over decades should be carefully questioned and replaced by standardized, evidence-based practices. This may safely decrease the cesarean rate. Given the practice environment and cultural and medical-legal pressures that clinicians face, however, the healthcare system will need to adopt systems approaches to decrease the national cesarean delivery rate. Quality improvement and tort reform efforts will allow clinicians to adopt the range of practices described here. Without such environmental changes, however, clinicians may not be able to alter practice patterns that have been the norm for so long.