C-Section Rates Are at All-Time High
U.S. Has About 1.4 Million Cesarean Births Each Year
March 23, 2010 -- Cesarean deliveries have reached an all-time high in the
U.S., with nearly one in three babies now delivered by C-section compared to
one in five just a decade ago, new government figures reveal.
Roughly 1.4 million newborns were delivered surgically in 2007 -- a 53%
increase from the mid-1990s, when rates started to climb after remaining steady
for several years.
Rates rose for both older and younger mothers across all racial groups and
all regions of the U.S., making cesarean delivery the most commonly performed
surgery in the nation.
The C-section rate increased by annually between 1996 and 2007, from a low
of 21% to 32%.
"Every state has seen an increase in cesarean sections over the last decade
and rates continue to climb," National Center for Health Statistics (NCHS)
statistician Fay Menacker, DrPH, tells WebMD.
The new figures were published today by the NCHS, which is a division of the
Vaginal Birth After Cesarean
The NCHS report did not address the reasons for the decade-long rise in
C-section deliveries, but an expert panel convened by the National Institutes
of Health weighed in on the issue a few weeks ago.
The panel looked at why so few women in the U.S. who have had C-sections are
having nonsurgical deliveries for subsequent births.
The practice, known as vaginal birth after cesarean, or VBAC, was common in
the mid-1990s. But today, fewer than one in 10 women who have had a previous
C-section attempt labor.
Studies suggest that 75% of women who labor with a pregnancy that follows a
C-section delivery successfully have a vaginal birth, and outcomes are also
good in the vast majority of cases where VBACs are unsuccessful and surgical
delivery is required.
But in slightly less than 1% of cases, VBACs lead to uterine rupture, a
potentially catastrophic complication for both mother and baby, panel chairman
F. Gary Cunningham, MD, tells WebMD.
Several leading medical groups now call for a surgeon and anesthesiologist
to be available when a woman who has had a previous C-section attempts labor,
and this guideline has led many hospitals to stop offering VBACs, he says.
In recent surveys, about 30% of hospital administrators said their hospitals
stopped performing VBACs because they could not comply with the guideline.
Uterine rupture often leads to fetal death or brain damage. When this
happens, hospitals and ob-gyns are often sued and massive settlements are not
"Their position is understandable. You can't make a hospital offer VBACs,"
Cunningham says. "But on the other hand, there is a growing voice out there of
women who would like a trial of labor, but it is not available to them."
The panel concluded that VBAC is a safe alternative to C-section for most
low-risk women who have had just one prior surgical birth, Cunningham says.
Panel members also called for ob-gyns to discuss VBACs with appropriate
patients and honor their patients' delivery preferences whenever possible.