Rates for Total Cesarean Section, Primary Cesarean Section, and Vaginal Birth After Cesarean (VBAC), United States, 1989-2012

The national U.S. cesarean rate in 2012 was 32.8%.The national cesarean rate has not changed since 2010 when it declined slightly from 32.9% in 2009, the only dip since 1996. Cesarean section is the most common operating room procedure in U.S. hospitals. Overuse of this procedure is associated with excess morbidity in women and babies.1 For both commercial and Medicaid payers, total maternal-newborn costs are about 50% higher for cesarean compared with vaginal births.2

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).

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.

1 American College of Obstetricians and Gynecologists and Society for Maternal-Fetal Medicine. Safe Prevention of the Primary Cesarean Delivery. March 2014.
Available at http://www.acog.org/Resources_And_Publications/Obstetric_Care_Consensus_Series/Safe_Prevention_of_the_Primary_Cesarean_Delivery.
2 Truven Health Analytics. The Cost of Having a Baby in the United States. Ann Arbor: Truven, January 2013.
Available at http://transform.childbirthconnection.org/reports/cost.

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 http://www.cdc.gov/nchs/nvss/vital_certificate_revisions.htm.

cesarean and vbac rate table 2005-2012

U.S. National Center for Health Statistics

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.

The following resources are available on this website:

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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.
Most recent page update: 3/11/2014