Does the increasing cesarean section rate reflect a shift in indications or a decline in quality?

The cesarean section rate is continuously increasing at our department, fro m 13.8 to 17.2% between 1999 and 2000. The mother's wishes regarding the mo de of delivery weigh increasingly on our obstetric decisions. Patient accep tance of elective cesarean section is high, and the increasing cesarean sec tion rate is influenced by paramedical factors. Obstetrics appears to be de veloping into a mostly surgical discipline. The effect this has on quality land costs) remains to be seen. Copyright (C) 2001 S. Karger AG, Basel.