From a publication in the National Library of Medicine: The maternal mortality rate after cesarean section is currently very low, but cesarean section is more hazardous than vaginal delivery by a factor of 2-11. Maternal mortality rates of 0 in large series of cesareans have been achieved in some settings, and this suggests that careful attention to good surgical technique and postoperative care could lower mortality after cesarean even further. Infection is the most common cause of morbidity after cesarean, transfusion being second. A large number of factors modify the risk of infection, the most important being prophylactic antibiotics. There is weak evidence that women are slightly more depressed after cesarean than after vaginal delivery. On average, cesarean sections cost more than vaginal deliveries.

From childbirth.org: Cesarean birth is major surgery, and, as with other surgical procedures, risks are involved. The estimated risk of a woman dying after a cesarean birth is less than one in 2,500 (the risk of death after a vaginal birth is less than one in 10,000). These are estimated risks for a large population of women. Individual medical conditions such as some heart problems may make the risk of vaginal birth higher than cesarean birth.

A good clip from South Florida Parenting Magazine: How and why the rate of cesarian sections is increasing - and what expectant parents should know to avoid the risks of surgery.

It's a telling sign of the times that the hospital with the state's highest rate of deliveries, where more babies are delivered by cesarean section than vaginally, last year was chosen by South Florida Parenting readers as the best place in Miami-Dade County to give birth.

A generation ago, expectant mothers nationwide demanded relief from the rising rate of what they saw as needless butchering. Their outcry inspired doctors to drop their scalpels and with it, the rate of c-sections nationwide. Through much of the 1990s, cesarean deliveries hovered just above 20 percent of all births. Then around 1997, c-sections began to climb once again. Today, 27 percent of babies born in the United States are delivered by c-section - the highest level ever reported, and the numbers continue to increase each year. In Florida, the rate is just over 30 percent. Miami-Dade County has the highest rate in the state, more than 40 percent. Palm Beach and Broward aren't far behind.

Mothers this time are strangely silent, accepting, even embracing, the growing likelihood that giving birth will involve major surgery.

"The general attitude of the more informed mothers is not to take any chances," said Dr. Nathan Hirsch, chairman of obstetrics and gynecology at South Miami Hospital, which has the state's highest c-section rate, nearly 54 percent. "They say I'm only going to have one baby, maybe two."

How did surgery come to be seen as a safer way of giving birth than the way nature intended?

An Illusion of Safety: A clue lies in the state Agency for Health Care Administration's statistics showing the rate of c-sections in Florida and the United States. Although Florida's rate over the past decade dipped and rose in sync with the rest of the country, it stayed consistently higher. The reason is Florida's high rate of malpractice lawsuits. A newly enacted amendment to Florida's constitution revokes a Florida physician's license to practice if he has three malpractice judgments against him. Doctors who've long lived in fear of lawsuits now are outright terrified.

"The medical-legal problems in America today don't allow the doctor to take any chances," Hirsch said. "Everyone expects a perfect birth and a perfect baby." Surgery does not guarantee a perfect baby. Infants delivered by cesarean are more likely than those delivered vaginally to suffer from respiratory distress. According to Family Practice News, 73 percent of infants delivered by elective c-section required resuscitation oxygen. Fourteen percent were admitted to an advanced-care nursery, compared to 5 percent of babies born vaginally. C-section babies also face a small risk of being cut during surgery. Scheduled c-section may result in a premature delivery if the due date is miscalculated.

"A c-section is definitely not safer," said Dr. Maureen Malee, chief of obstetrics at Jackson Memorial Hospital in Miami. "It's surgery." Almost any obstetrician would agree. It's the illusion of safety that drives them to the knife. "Some practitioners believe that if you provide a c-section," Malee explained, "you won't be faulted retrospectively."

They consider such problems as infant respiratory distress minor and easy to treat. Most babies born in respiratory distress are breathing normally within days. Nor do doctors worry excessively about hemorrhaging and uterine infections, which are more common in women who've had c-sections. Transfusions and antibiotics normally do the trick. The fear that drives them to perform c-sections on four out of 10 mothers is delivering a baby with brain damage. Obstetricians once believed that sparing babies the trauma of passing through the birth canal would drastically cut the rate of cerebral palsy and mental retardation. More recent studies have proven that brain disorders are rarely related to childbirth, and that the surge in cesarean deliveries has not diminished the incidence of cerebral palsy.

Obstetricians know of the studies, yet they also know how easily jurors can be swayed by testimony from "medical experts" who'll say that if the doctor had only done a c-section, the baby would have been fine.