I was just coming back to post something similar Marydean. My friend recently had an elective section and her first birth was like something from a horror film. They intervened in every way possible, kept her strapped to the bed, took ages giving pain relief then mucked up the dose, eventually giving her a foceps delivery for her "he's just too big" baby who turned out to be just over 6lbs, and caused a haematoma inside her vagina which ruptured 3 times in the following days, causing her to need 3 more surgeries and 15 units of transfused blood. The same hossie wouldn't let her even think of attempting VBAC.

To me the epidural rate speaks more than the section rate because a well-supported woman having an uncomplicated birth probably WON'T need one. The epidural rate of my hospital put me off because it made me think probably there was no good support. I have since learned they do not assign midwives for a whole shift to one woman and routinely kick dads out at 10pm unless mum is actually pushing. No wonder so many women end up having spinal anaesthesia - alone and labouring without consistent care in the night...

Routine postnatal debrief and follow-up with patient-scored performance reports would be more useful than section rates alone.

Bx