C/s rates are indeed rising for many reasons, especially the decrease in
trials of labor after previous c/s, much of which is fueled by the
enormous rise in malpractice premiums causing malpractice insurers
(including mine) to require strict, rather scary informed consent
documents before VBAC; and hospitals' (and obstetricians) subsequent
refusal to let midwives and family physicians attend VBAC deliveries.
They are all managed/attended by OB's now in most places.  For lots of
reasons that often have more to do with surgical training and point of
view than the economic motive sometimes ascribed, OB's tend to have higher
C/S rates than FP's and midwives, even when risk level is equal.

The induction issue is also a concern as others have mentioned.

One disturbing trend I'm also seeing is scheduled primary C/S without
labor because a baby is "big" and/or because the mother requests/demands
it.  I recently read an article in a "health" magazine touting a pregnant
woman's right to have a cesarean section without labor if that is her
preference.  Scary.

Anne Montgomery, MD, IBCLC
Family Physician (doing maternity care) and LC
Olympia, WA

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