Sure they aren't the majority, but even having 25% of births be primary cesarean is ridiculous. The rate of cesarean for low-risk births is driven by policy, tradition, and unfortunately also profit motive. Simple changes in policy have dramatic influence on the cesarean rate, which strongly implies that the procedures were not medically indicated. For example the rate of cesareans for ordinary full-term, low-risk births in the US declined 6 percentage points after 2009, simply because the ACOG put out a statement about them. WHO says that the rate should be 15%, leaving half of US cesareans unexplained by medical necessity.