Understanding Cesarean Rates

Current public health efforts in the United States focus on reducing the overall number of medically unnecessary cesarean births among a specific population-- first-time moms with potentially "low-risk" births, meaning that they have a single, full-term baby in the head-down position. The cesarean birth rate in this population is called the NTSV cesarean birth rate.

Centers for Disease Control and Prevention data from 2017 show that 32% of all births were by cesarean and  26% of the NTSV ("low-risk") population had cesarean births.

U.S. Total and NTSV Cesarean Rates, 1993-2017

The Healthy People 2020 target for the NTSV C-section rate is 23.9%. There is no target for the total cesarean rate.
 

Data table and sources

 

Available CDC data show that the NTSV cesarean birth rate was as high as 28.1% in the United States, reaching this peak in 2009.

Unfortunately, 87.6% of women with a history of a previous cesarean birth have a repeat C-section, as many hospitals and doctors offering maternity services do not permit women with a history of cesarean birth to give birth vaginally at their facility. Multiple repeat cesarean births dramatically increase the risk of dangerous long-term complications, such as placenta accreta.

 
 

Percentage of Repeat Cesarean Births vs. VBAC, 2016

CDC reports a national VBAC (Vaginal Birth After Cesarean) rate of 12.4%. Of the nearly 4 million births (whether vaginal or cesarean) in the U.S. in 2016, CDC reports that 601,778 were women with a previous C-section.
 
 

 

Place of birth matters.

Where a person chooses to give birth impacts their likelihood of having a C-section. The hospital itself is considered an independent risk factor for a cesarean birth.

Current research shows that most people didn't think their choice of hospital had any impact on whether or not they would have a cesarean birth. Although regarded as one of the important measures of a hospital's performance, one study found that only 28% of its survey respondents used quality information to choose a hospital for their birth.

 
 
 

Rates vary dramatically between hospitals.

A 2013 University of Minnesota study identified 10-fold variation in hospital-level cesarean rates-- from 7 percent to 70 percent. The variation was more extreme in patients with lower-risk births. Rates of cesarean birth varied 15-fold in this population.

At present, the best sources of information for patients on hospital cesarean rates only feature data from half of hospitals with maternity services. Some state departments of health make these data available, but the type of cesarean birth measure varies from state-to-state, making understanding the concept of a cesarean rate confusing to the public. Click the button below to learn more about how cesarean use is measured.