Cesarean section in California—1960 through 1975

Trends in Cesarean Section Rates for the United States, 1970–78

“…Also, in a trend study of 323 California hospitals, Williams and Hawes found that the C-section rate rose from 5.2 percent in 1966 to 15.4 percent in 1977, primarily in hospitals where labor was electronically monitored (15). In a similar 1960-75 trend study in California, Petitti and co-authors also suggested that electronic monitoring was the factor responsible for the rise (16). A higher rate of monitoring and of C-sections among traditionally low-risk women may reflect the existence of more "concern," and consequently more technical treatment, for middle-class women, rather than establish a direct cause-and-effect relationship between monitoring and C-sections.…”

Investigation of institutional differences in primary cesarean birth rates

“…It seems clear from our results and from other studies 36,37,44 that divergence in management of labor and delivery is a likely explanation for the differences in cesarean birth rates. The continued rise in cesarean births must be questioned in the face of these differing labor and delivery management styles as well as the higher risk of morbidity among women with primary cesarean deliveries 19–22 and the uncertain benefits to the newborn 25,24 …”

“…A number of reports point to recent changes in diagnostic technology and management of obstetric problems, including cesarean birth, as clearly benefiting the newborn 13–19 and not harming the mother 17 . Yet, maternal mortality and morbidity is considerably higher among women delivered by cesarean than for women delivered vaginally, 19–22 and doubts have recently been raised about the benefits of cesarean birth for the infant 23–24 particularly in view of its cost 25–26 …”

Indications des césariennes à l’Hôpital de Zone de Nyon (1973–1982)

“…Dans le premier cas, la baisse de cette indication, souvent liée à la notion d'induc tion pour terme dépassé [13], est peut-être due à l'introduction systémati que de l'échographie en obstétrique (dès 1978), qui permet de déterminer le [9], Ceci d'autant plus que la valeur pronostique de la radiopelvimétrie est contestée et sup plantée par l'épreuve de travail [9]. C'est l'attitude de ce service depuis 1978.…”