Cesarean Delivery and the Risk–Benefit Calculus

Abstract

In 1937, an article in the Journal describing 10 years of births at Boston City Hospital revealed an overall rate of cesarean delivery of about 3%.¹ Recently released 2005 data on cesarean deliveries show that contemporary rates are 10 times as high, having climbed above 30% (see graph ).² Indeed, of the 20th century's many changes in obstetrical care — the wholesale move from home to hospital delivery, increasing use of anesthesia, the advent of in vitro fertilization — few have generated more attention and debate or had a greater effect on the process of delivery than this seemingly inexorable rise.