British consultants' attitudes to caesareans

The caesarean rate more than doubled between 1990 and 2004. In this paper, 151 clinical directors give their views about this development. The three main reasons they gave for the rise were: fear of litigation, maternal request and reduced skill of newly appointed consultants and non-consultant staff. However, they provided about 90 reasons overall. Three in five of the consultants thought the local rate was too high; two in five thought it about right; and only one in 74 said it was too low. The major suggestions they gave for reducing the rate were that there should be more consultant input, an increased amount of VBAC, better education of women and discussion at weekly meetings. In addition, three-quarters agreed with 'no fault compensation' in the case of brain damage.