[The epidemic of cesarean sections: a necessary evil?]

The proportion of cesarean deliveries has raised worldwide, to reach 29% in Switzerland, with important differences between public and private hospitals. There is no simple explanation to this. The emphasis on safety is no excuse, as cesarean sections have short and long-term risks. In this article, we try to understand the reason of this epidemic and we discuss the benefits and risks of cesarean section. This intervention should be performed for medical reasons only. Maternal demand is acceptable, only after a real informed consent. While simplification of surgical techniques and loco-regional anesthesia made cesarean safer, it should not become commonplace. To respect physiology is obstetrician's primary duty, corresponding to the wish of women. Hospitals and clinics have to publish their cesarean section rate.