Cesarean Section in the US The most common major operation performed in the United States ia a Cesarean section. 16 US hospitals had Cesarean section rates of 45% or higher in 1994. 106 hospitals had Cesarean section rates of 37% or higher in 1994. About half of the Cesareans done in the US in1991 were unnecessary. This cost Americans more than $1.3 billion. The women having Cesarean sections are the ones least likely to need them. The World Health Organization states that there is no justification for having a Cesarean rate higher than 10-15%. The risk of maternal death associated with Cesarean section is two to four times that associated with vaginal births. Midwife-attended birth is associated with low rates of Cesarean section. Obstetricians who work with midwives have lower rates of intervention. The World Health Organization states that countries with some of the lowest perinatal mortality rates in the world have cesarean rates under 10%. Evidence and peer education do not change standards of practice. The greatest danger arises from ruthless application of partial knowledge on a vast scale. E.F. Schumacher