Florida is seeing more babies delivered by C-section

Yes, but: An increase in C-sections doesn't necessarily mean the rate of unnecessary procedures has risen. There are other factors at play.

Patients are sicker overall.

• With gestational diabetes and hypertensive disorders in pregnancy on the rise, there could be a greater need for C-sections, says Jane van Dis, OB-GYN and assistant professor at the University of Rochester.
• It's her hypothesis that the rise in those conditions is due to "environmental exposure," and she cites the increasing use of plastics.

Repeat C-sections account for many procedures, even though the old "too posh to push" idea is not widely held.

• "If you have already had a C-section, you will almost always be offered — and indeed the default is likely to be — a second," says Emily Oster, economist and author of "The Unexpected."

Between the lines: Hospital politics might also come into play.

• For example, there are cases when doctors are more inclined to perform C-sections, because that option may be less likely to lead to a medical malpractice lawsuit, van Dis says.

• And health care system reimbursements for C-sections are generally higher than for vaginal births. "Financial incentives almost always play some role," Oster says.

What we're watching: Expanding access to doula care could lower the rates of C-sections.

• A number of studies already suggest that the presence of doulas lower the use of C-sections, Oster says.
• Doulas are there for psychological support during the often-overwhelming labor process, and to help with birth positions that could avoid the need for a C-section, van Dis says.