The rise of the caesarean section: a review

Caesarean section is of recent development as a credible procedure. A rapidly increasing incidence in many countries has led to a far-ranging concern. Proposed causes for the increase include insistence on repeat operations and a resultant cumulative effect, more frequent diagnoses of disproportion and ineffective labour, the use of fetal heart monitoring, and a steady trend away from vaginal breech delivery. Increased perinatal morbidity is seen in Caesarean section, together with a qualified increase in perinatal mortality. Maternal morbidity is greater and maternal death rates are reportedly 2-4 times greater in Caesarean section births. More work is needed on the psychosocial sequelae of abdominal delivery.