All in Leadership

We leave the parking lot, riding side-by-side up a short stretch of fire road before cutting left onto a rock-strewn creek bed that climbed sharply. Making it to the top requires choosing a path that navigates boulders, gravel, damp leaves, and roots - and then executing. Gravel can spin; boulders may be insurmountable; leaves and roots are slippery when damp. The hill is steep enough that the wrong choice would bring me to a halt. I carefully select a good line and push forward, breathing hard.

In the 15 years I have practiced obstetrics, I have been the surgical assistant on hundreds of cesarean deliveries that seemed to me, at the time, to be unnecessary, and I’ve been the surgeon of record for a handful of unnecessary cesarean deliveries myself. I know firsthand how difficult it is for physicians, nurses, policy makers, and administrators, all of whom are well aware that the United States has a cesarean epidemic, to wrestle with it.