On the front page of Sunday's Philadelphia Inquirer is a shocking expose on what I think is a corruption of medical practice -- the fact that the once-risky (and distinctly icky if not unnatural) procedure of delivering babies by cesarian section is "now is used in about a third of U.S. births":

"This is mostly about changes in culture," said Eugene Declercq, an expert in maternal and child health at Boston University's School of Public Health. "In all the gray areas of clinical decision-making, obstetricians have moved to cesareans. Mothers are more accepting, too."

Cesarean critics worry that doctors are frightening mothers into the surgery.

"A woman who is given reason to be scared that something bad might happen to her unborn child will do anything to avoid it," said Jose Gorrin Peralta, a University of Puerto Rico obstetrician. "If the doctor says, 'Your baby could die unless I do a cesarean,' what woman is going to say, 'Don't do it'? I call it obstetrical terrorism."

Sure, it's easier to perform a c-section than ever before, but the rates are still four times that of a normal delivery. The Inquirer hints at economic factors:

....the specter of lawsuits heavily influences the use of cesarean.

At Lankenau, for example, the cesarean rate rose from 28 percent in 2001 to 36 percent the very next year. The jump was largely triggered by a lawsuit contending that a child was born with cerebral palsy because a cesarean was not performed. The parents won a $24 million verdict.

"You can imagine there is that fear of what can happen," said Nancy Roberts, the chief of obstetrics.

A Pennsylvania State University College of Medicine study of 31 hospitals found that the more physicians perceived they were at risk of being sued, the more cesareans they did.

I think it is a violation of the Hippocratic Oath for a doctor to take into account potential legal liability in deciding to cut a woman open instead of waiting for nature to run its course.

It's not preventive health care on behalf of the patient; it's preventive legal care on behalf of the doctor and the hospital.

Doctors, of course, counter that it isn't their fault, and a number of commentators have pointed the finger at John Edwards:

Edwards specifically has made much of his fortune suing doctors for not performing C-sections, arguing that they help prevent cerebral palsy in children. In 1970, six percent of all births were C-sections; in 2003, that number had climbed all the way up to 28 percent. However, as John Stossel reports, there had not been a decrease in prevalence of cerebral palsy during that time. Hence, although Edwards' lawsuits have not, apparently, prevented anycases of cerebral palsy, they have, at least in part, yielded a great increase in the occurrence of C-sections. Now doctors do C-sections "just to be safe," meaning safe from lawsuits, though the procedure is not so safe for mothers. While C-sections are not overly dangerous, women are four times more likely to die during a C-section than during vaginal birth; this is not an insignificant risk.

Medical malpractice was his specialty, and he reportedly tried more than 60 such cases, winning more than $1 million in over half of those. Most involved Ob/gyns. Indeed, he was so feared, according to the Center for Public Integrity, "that doctors would settle cases for millions of dollars rather than face him at trial."

Edwards' specialty was cerebral palsy, a set of permanent conditions affecting control of movement and posture that usually appear at toddler stage. There is no cure, although stem cell studies in both humans (umbilical cord cells) and rats (neural cells) have produced promising results. More than 10,000 U.S. children are diagnosed with it yearly. Edwards claimed the disease developed because negligent doctors ignored fetal heart monitors indicating the child might not be getting enough air during birth and thus failed to deliver it immediately through cesarean surgery.

Yet Edwards won his cases not because scientific evidence favored him but because of his smooth-talking "trust-me" demeanor -- and heart-wrenching pleas in which he ghoulishly sometimes pretended to be the voice of the unfortunate child crying out for justice.

in what's called "defensive medicine," lawsuit fears increased the number of "When in doubt, cut it out" C-sections. Cesareans in the U.S. had begun dropping in the late 1980s, going as low as 22 percent of deliveries. As Edwards and friends spread fear across the Ob/gyn land, rates began to climb again. The rate is now 30.2 percent, a record high for the nation.

There are probably many reasons for the increased popularity of C-sections, before and after the Edwards era. One is that women often choose it over the pain of labor Dr. Bruce Flamm, clinical professor of Ob/gyn at UC Irvine, told me. Still, "The biggest reason is probably the litigation issue" he said.

Photos released by the Edwards campaign often feature him surrounded by his wife and kids. No doubt he loves them very much. It's too bad he thinks so little of the families of others.

I'm not saying this is the Inquirer's fault, either.

There's just too much money involved, and too much money is why there will never be meaningful tort reform, as trial lawyers like Edwards fill the coffers of the Democratic Party money machine.

But Edwards is a man of the people, right? There's been some discussion recently which was linked by Glenn Reynolds to the effect of how unfair it is that rich guy like Edwards is seen as phony whereas in the old days, the sincerity of patricians like FDR went unquestioned. I agree with Glenn that identity politics is largely to blame -- because it assumes that in order to speak for the poor, you must be poor, in order to speak for a woman you must be a woman, etc.

....FDR was a rich guy who cared about the poor, he says, so why can't John Edwards be?

Well, John Edwards is no FDR. But the answer to Krugman's complaint is found in the post 1960s political zeitgeist. Back before identity politics, and the notion that "the personal is political," the idea of a rich guy representing poor people was entirely plausible. He could be rich, but still have ideas about poverty, and care about them. But now that we have identity politics and the like, that's impossible: If only a woman can represent women, only a black person can represent blacks, etc. -- Barbara Boxer even suggested that Condi Rice couldn't understand mothers because she was childless -- then obviously only a poor person can represent poor people. And since there are no poor people in American political office, poor people perforce go unrepresented. Thus, the "progressive" causes of identity politics and personalization mean that the progressives' key clients can't get "authentic" representation. This is probably bad for the country, but it's certainly a bed that the progressives have made for themselves.

His father James Roosevelt was heir to a huge coal and railroad fortune, while his mother Sara Delano was heir to an opium fortune amassed by her drug-smuggler father. Such a background might (along with heavy influence of Endicott Peabody) well have contributed to the development in young Franklin a sense of guilty noblesse oblige, and a genuinely earnest desire to help the poor.

No matter what might be said about the sources of FDR's parents' income, no one can say that he made money by taking it from the needy (especially in the form of 40% contingency fees).

I agree that John Edwards is no FDR.

And while I don't agree with the way identity politics has thwarted genuine noblesse oblige, I don't think the man has any more moral authority to speak for the poor than anyone else.

I'm not even sure that Edwards has earned the moral authority to speak for the handicapped babies he's enriched, because he's taken so much of their money doing it.

What about the pregnant women who've been hoodwinked into having themselves cut open unnecessarily by obstetricians fearful of Edwards-style litigation? While it might not be "legal terrorism," it sure isn't FDR-style moral authority.