The cesarean birth -- delivery via uterine incision -- was once reserved for cases in which the life of the baby or mother was in danger. But it is now routine. It is in fact the most common operation in the U.S., performed in 31 percent of births, up from a mere 4.5 percent in 1965.

With that surge has come an explosion in medical bills and an increase in complications. Now, the use of cesareans is being reconsidered. It is a major reason childbirth often is held up in healthcare reform debates as an example of how the intensive and expensive U.S. brand of medicine has failed to deliver better results, and may actually be doing more harm than good.

Childbirth is the number one cause of hospital admissions, and is a huge part of the nation's $2.4-trillion annual healthcare expenditure. Spending on the average uncomplicated cesarean runs from $4,500 to $13,000, much more than a comparable vaginal birth. And the cesarean rate in the U.S. is higher than in most other developed nations despite a standing government goal of reducing such deliveries.

 
The cesarean also exposes a woman to the risk of infection, blood clots and other serious problems. Cesareans have been shown to increase premature births and the need for intensive care for newborns. Even without such complications, cesareans result in longer hospital stays.