By the
late 1970s, a woman arriving on the labor and delivery floor of a U.S. tertiary care hospital with a nonmalformed, living,
singleton fetus at term had a risk of intrapartum fetal death of 1 in 1000.1 At that time the U.S. cesarean delivery rate was approaching 15 %.2 Since then, the rate of cesarean sections has more
than doubled, 3 but the intrapartum fetal death rate in major U.S. centers remains unchanged.