Preterm Birth and C-Section Rates Up
Surgical Deliveries Continue Rapid Rise, CDC Says
Nov. 15, 2005 - Preterm births reached an all-time high in 2004, numbering
half a million for the first time in the U.S., according to federal statistics
The figures also show a continued rapid rise in the use of cesarean delivery
among U.S. women. C-section rates rose 6% in 2004 and have gone up 40% since
1996, worrying some experts that not enough attention is being paid to the
Joyce Martin, a researcher with the National Center for Health Statistics at
the CDC, tells WebMD that preterm and low-weight births have been on a
"slow but steady" rise for a decade.
The Role of Multiple Births
Part of the reason is an increase in multiple births, which are more likely
to be premature or low-weight, she says. Martin attributes rising multiple
births to increased pregnancy rates among women in their 30s and 40s, who are
more likely to give birth prematurely and more likely to use fertility drugs
that can lead to twins.
"Other reasons are just not clear," Martin says.
The report found a slight decrease in smoking among pregnant women, though
10.2% of women still smoked during their pregnancies in 2004.
At the same time, C-section rates reached 29.1% of all births in 2004, the
highest number ever recorded in the United States. C-sections during women's
first pregnancies were also up.
Patients of all ethnic groups were more likely to have C-sections,
suggesting that the procedure is increasingly popular with doctors.
Why C-Sections Are Popular
Experts point to several possible factors -- including fashion -- boosting
the popularity of C-sections among women in their first pregnancy.
"There isn't any specific study that you can link the trend to,"
says Eugene Declercq, PhD. Declercq is a C-section researcher and a professor
of maternal and child health at the Boston University School of Public
Doctors may be practicing more C-sections as a way to avoid liability
lawsuits. More mothers may also be asking their doctors for C-sections because
of the increased convenience of choosing the time of delivery and because of a
desire for less painful childbirth, he says.
In addition, C-section has simply become part of popular culture. "When
Britney Spears has an elective C-section, it's all over the place,"
But if convenience is a factor, it may be misplaced, he warns. "I'm not
sure how convenient it turns out to be for mothers because they're in the
hospital longer and it takes longer to recover" after C-sections,"
Declercq tells WebMD.
'We've Gone Too Far'
Sarah Kilpatrick, MD, the chief of obstetrics and gynecology at the
University of Illinois at Chicago, called the increasing C-sections rates
Kilpatrick agrees that more doctors are caving to patient demands for
elective cesarean births.
But the trend may be ignoring evidence that repeated C-sections increase the
risk of dangerous placental abnormalities in later pregnancies. More first-time
cesareans are now increasing the baseline rate of repeat surgeries later, each
of which carries progressively higher risks to both mother and newborn, says
Kilpatrick, who is vice chairwoman of the practice committee of the American
College of Obstetricians and Gynecologists.
"I don't think anyone has really thought to look at the long-term
consequences of this," she tells WebMD. "I think it's clear that we've
gone too far."