Abstract
The magnitude of cesarean section rates in the United States has been of increasing public concern. A consensus development conference in 1980 formulated recommendations that were expected to lead to a decrease in national cesarean section rates. A review of cesarean section patterns for the last five years in many representative states revealed, contrary to expectations, a continuing increase in cesarean section delivery rates even after the conference. A review of underlying causes for these developments suggests that only a more efficient peer review process, involving individual physicians as well as institutions, will lead to a decline of unacceptably high cesarean section rates in this country.
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