Rates for Total Cesarean Section, Primary Cesarean Section, and Vaginal Birth After Cesarean (VBAC), United States, 1989-2011
In October 2012, the National Center for Health Statistics released the preliminary U.S. national cesarean rate for 2011: 32.8%. This represents no change from 2010, signaling a plateau in the cesarean rate after over a decade of rising. Cesarean section remains the most common operating room procedure in U.S. hospitals. C-section involves considerable morbidity in women and babies and considerable expense for private payers/employers, Medicaid/taxpayers and women with out-of-pocket expenses.
See links below for some of Childbirth Connection's extensive resources about this procedure. For your use, we have also prepared a PDF hand-out of this c-section page (PDF).
Source: U.S. National Center for Health Statistics data were used to create this chart.
Note:
National rates of primary cesarean and VBAC are not available 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, 2005-2009.
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, patterns of use of primary cesarean section and VBAC have crucial implications for childbearing women and families; and 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 http://www.cdc.gov/nchs/nvss./vital_certificate_revisions.htm.
Source: U.S. National Center for Health Statistics data were used to create this table.
Notes:
By January 1, 2005, the following states migrated to use of the revised (2003) birth certificate: 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, seven additional states migrated to use of the revised (2003) birth certificate: California, Delaware, North Dakota, Ohio, South Dakota, Vermont, and Wyoming.
By January 1, 2007, three additional states migrated to use of the revised (2003) birth certificate: Colorado, Indiana, and Iowa.
By January 1, 2008 New York City and five additional states migrated to use of the revised (2003) birth certificate: Georgia, Michigan, Montana, New Mexico, and Oregon.
By January 1, 2009, one additional state migrated to use of to the revised (2003) birth certificate: Utah.
By January 1, 2010, the District of Columbia and five additional states migrated to use of the revised (2003) birth certificate: Illinois, Maryland, Missouri, Nevada, and Oklahoma.
The following resources are available on this website:
- Why the c-section rate is so high fact sheet
- What Every Pregnant Woman Needs to Know About Cesarean Section — booklet for learning about the issues and making wise decisions beginning in early pregnancy
- Mothering magazine article (PDF) describing the current birthing environment and illustrating typical labor in U.S. hospitals and cesarean surgical procedure
- mothers report cesarean section views and experiences — results from the national Listening to Mothers II survey
- c-section and vaginal birth after cesarean (VBAC) versus repeat cesarean section — in-depth coverage for pregnant women, including best evidence and tips for making decisions and achieving goals
- harms that differ in likelihood between cesarean section and vaginal birth (PDF) — summary of Childbirth Connection's systematic review
- charges for cesarean section and vaginal birth — chart with national average figures
- c-section resources and VBAC versus repeat cesarean section resources for learning more.
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Childbirth Connection is a national not-for-profit organization founded in 1918 as Maternity Center Association. Our mission is to improve the quality of maternity care through research, education, advocacy and policy. Childbirth Connection promotes safe, effective and satisfying evidence-based maternity care and is a voice for the needs and interests of childbearing families.
Childbirth Connection is a national not-for-profit organization founded in 1918 as Maternity Center Association. Our mission is to improve the quality of maternity care through research, education, advocacy and policy. Childbirth Connection promotes safe, effective and satisfying evidence-based maternity care and is a voice for the needs and interests of childbearing families.
Most recent page update: 11/19/2012