The Search for a Lower Cesarean Rate Goes On

Abstract

When physicians alter their practice patterns or employ new technology, the result may have a significant impact on health care costs. The most important consideration, however, is whether a modification of practice pattern enhances the eventual medical outcome. Today's obstetrician employs cesarean delivery much more frequently than the practitioner of a generation ago, who was likely to consider a cesarean delivery rate of less than 5% a hallmark of good obstetric practice. The reasons for this dramatic change in the use of operative delivery, which now has reached a national level of almost 25%, are many and somewhat difficult to evaluate. Enhanced patient expectations for a perfect obstetric outcome have spurred the use of changing practice patterns and various new technologies, prior to and during labor and at the time of delivery. Once physician practice patterns are entrenched, they become difficult to modify in the absence of sound scientific studies