The identification of a subpopulation of infants delivered by cesarean section who have a very low risk for requiring neonatal resuscitation represents a vital step toward the allocation of health care resources associated with such deliveries. The data presented by Rothstein et al support the observation that patients delivered by repeated cesarean section under regional anesthesia have a similar risk for requiring neonatal resuscitation as do patients delivered vaginally. Therefore, provision of the same medical support for infants delivered by repeated cesarean section under regional anesthesia that is provided for infants delivered vaginally would appear to be reasonable. We agree with this assessment, but with caution.
The American Academy of Pediatrics and the American Heart Association currently recommend (and instruct) that "at every delivery there should be at least one person... who has the skills required to perform a complete resuscitation. He or she must be skilled in