Premature Concerns for Cesarean Sections?

The article by Gleicher1in this issue ofThe Journalonce again documents the very important need to continue to evaluate the high rates of cesarean births while maintaining improved outcomes. Dr Gleicher suggests that even at this early date, the Consensus Development Conference should have resulted in altered obstetrical practices. For several reasons I suggest that this argument may have been prematurely raised. The Consensus Development Conference on Cesarean Child-birth was held from Sept 22 to 24, 1980. The audience at that time was approximately 300 persons. At least half of those present were members of the lay press and nonobstetricians who had concerns with the problem of high cesarean birth rates. Thus, the educable audience was indeed limited. The first reports of the conference were published in two major obstetrical journals2,3in April 1981. Finally, the official conference document was published in October 1981. If we