LETTERS

When a high C-section rate is an advantage

During the 1980s, I took pride in having the lowest C-section rate at my hospital: I delivered more than 220 babies a year with a primary rate of 12%. I delivered twins and breech presentations vaginally and was skilled with Laufe divergent forceps.

Some time during the 1990s, I reconsidered my approach. What if my birth outcomes were not so routinely good? Would I be able to defend the tactics I used to effect delivery? Could I defend myself with any breech birth?