Cesarean Section Trends, 1989-2014

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The preliminary national cesarean rate for 2014 is 32.2 percent of all births. This is a slight drop from the national peak of 32.9 percent in 2009. Cesarean section is the most common operating room procedure in U.S. hospitals. Overuse of this procedure is associated with excess health problems in women and babies.1 For both commercial and Medicaid payers, total maternal-newborn costs are about 50 percent higher for cesarean compared with vaginal births.2

cesarean and vbac rate chart 1989-2012
Source: U.S. National Center for Health Statistics

Note: National rates of "primary" or initial cesarean among pregnant women who have not had a prior cesarean and VBAC are unavailable from 2005 onward due to jurisdictions' use of both unrevised (1989) and revised (2003) birth certificate forms, with different methods of data collection. See the following table for the primary cesarean and VBAC rates in jurisdictions using the revised form, 2005-2012.

Data are not available to delineate national trends in rates of primary cesarean section and vaginal birth after cesarean (VBAC) from 2005 onward, due to the pattern of adopting the revised (2003) birth certificate form across jurisdictions over time. However, there is widespread concern about overuse of cesarean section and lack of access to VBAC. The following birth certificate data are provided to help understand recent patterns of use. It would be inappropriate to compare figures from year to year due to the changing demographic composition of the cohorts as jurisdictions migrate to the revised 2003 form. For extensive information about the 2003 birth certificate revisions, see

cesarean and vbac rate table 2005-2012
Source: U.S. National Center for Health Statistics

Note: States and jurisdictions have migrated to use of the revised (2003) birth certificate as follows:

By January 1, 2005: Florida, Idaho, Kansas, Kentucky, Nebraska, New Hampshire, New York State (excluding New York City), Pennsylvania, South Carolina, Tennessee, Texas, and Washington.
By January 1, 2006: California, Delaware, North Dakota, Ohio, South Dakota, Vermont, and Wyoming.
By January 1, 2007: Colorado, Indiana, and Iowa.
By January 1, 2008: New York City and Georgia, Michigan, Montana, New Mexico, and Oregon.
By January 1, 2009: Utah.
By January 2, 2010: Illinois, Maryland, Missouri, Nevada, and Oklahoma.
By January 1, 2011: Louisiana, North Carolina, and Wisconsin.
By January 1, 2012: Massachusetts and Minnesota.
By January 1, 2013: Alaska, Mississippi, and Virginia.

Learn More

Learn more about cesarean section in the following Childbirth Connection resources:

1 American College of Obstetricians and Gynecologists and Society for Maternal-Fetal Medicine. Safe Prevention of the Primary Cesarean Delivery. March 2014.

2 Truven Health Analytics. The Cost of Having a Baby in the United States. Ann Arbor: Truven, January 2013.

Most recent page update: 9/3/2015

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