The rate of CS was estimated by the Royal College of Obstetricians and Gynaecologists to be 15 per cent in England in 1993, whilst in Scotland and Wales the rates are higher.
In 1978, when the US rate of CS rose to 15 per cent it was recognised that a public health problem existed and a task force was set up to examine this. It took another 15 years before the rate stopped rising, peaking at 24.8 per cent, and in 1994 it had fallen to 23.6 per cent. The rate has risen more slowly in the UK but is over 15 per cent now. I estimate that half those operations are unnecessary and many could be avoided by following the excellent advice given by Sheila Kitzinger.
WENDY SAVAGE FRCOG
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