Cesarean Births Reach Record Number in U.S.

< Dec. 22, 2010 > -- Cesarean births in the U.S. have reached a record high, according to a new report. C-sections now make up nearly a third of births in this country.

The trend toward cesarean births started in 1996, with rates climbing across all age and ethnic groups.

The growing number of C-sections is troubling for medical experts, who point out that cesarean births often carry a much higher risk for complications than vaginal births.

“And with [subsequent] C-sections, complications go dramatically higher, bleeding, hysterectomy, even death," says Mitchell Maiman, M.D., at Staten Island University Hospital in New York City.

C-sections are clearly called for in certain cases – if the mother has preeclampsia or diabetes, for example. But reasons for the current trend range from women’s preferences to doctors' fears of lawsuits, experts say.

Latest figures

The birth statistics actually apply to 2008, the latest figures available and just released this week by the National Center for Health Statistics and the Johns Hopkins Bloomberg School of Public Health. The good news is that although the number of C-sections is at a record high, the increase from year to year has been declining since 2002.

Efforts to counteract the C-section boom have resulted in growing support for VBAC (vaginal birth after cesarean), in which a mother is given the option of delivering vaginally, even though the previous birth was by C-section.

Other statistics about birth from the new report:

• The birth rate among women 40 and older increased 4 percent from 2007 to 2008 and is now the highest rate seen in 40 years.

• Births to teens ages 15 to 17 declined 2 percent from 2007 to 2008, after an increase from 2006 and 2007. That increase reversed a 14-year decline charted since 1991.

• The proportion of babies born early went down 3 percent from 2007, and is now at 12.3 percent of all births.

• Rates of multiple births stayed the same.

• Infant mortality declined 2 percent between 2007 and 2008, from 6.75 per 1,000 live births in 2007 to 6.59 in 2008.

Is a VBAC for You?

If you’ve had a cesarean section, you may be able to deliver vaginally for your next pregnancy if you have no other risk factors, the American College of Obstetricians and Gynecologists says.

Why attempt a VBAC (vaginal birth after cesarean)?

• Lower risk. A vaginal delivery usually has fewer complications than cesarean birth. A C-section requires major surgery and is performed under anesthesia. The major risks of VBAC are that the cesarean scar may tear during delivery or that the uterus will tear.

• Shorter recovery. Your stay in the hospital often is shorter after a vaginal delivery, and you’ll usually have less discomfort than after a cesarean birth.

• More involvement. Because general anesthesia is sometimes used during cesarean delivery, you can’t always remain awake during the birth. And the hospital may place restrictions on who may be in the delivery room with you during a C-section.

Of course, you and your doctor will need to consider a number of other factors before deciding on a VBAC. These include the type of incision made during the previous C-section, the size and position of the baby in the womb, and medical conditions such as high blood pressure or diabetes.

Women attempting a VBAC should begin labor with close medical supervision in a hospital capable of emergency C-sections.

Always talk with your health care provider to find out more information.