The rate of Caesarean sections in the US has climbed to an all-time high, despite efforts to bring them down.
According to the National Center for Health Statistics, about 1.2 million C-sections were performed in 2004—29.1 percent of all births that year, up from 27.5 percent in 2003 and 20.7 in 1996.
The C-section rate increased for all births, even those that involved healthy, first-time pregnancies with a full-term, single child. The government announced in 2000 a national public health goal of reducing the C-section rate for such births to 15 percent by 2010, but the actual rate now is 24 percent, and is on the increase.
The increase is attributed to fears of malpractice lawsuits in the event of a vaginal delivery going wrong, preferences of mothers and physicians, and the risks of attempting vaginal births after Caesareans.
A C-section is major surgery which involves cutting open a women's abdomen to retrieve the baby. The risks include infection and, in rare cases, death. The recovery time is longer than with a vaginal delivery. It is performed when the fetus lacks oxygen or is in life-threatening distress.
For decades, C-sections were done only in fewer births. In 1970, it was as low as 5 percent. By the mid-1980s, it exceeded 20 percent. This was because mothers increasingly preferred the convenience of C-sections, which could be scheduled, and technological innovations enabled doctors to better see the problems before birth.
By the late 1990s, health insurers had cut back their C-section control efforts. Also, studies that showed that women who deliver vaginally after having a C-section earlier suffer a ruptured uterus — a potentially lethal complication for both mother and child — in about 1 percent of such cases, worried doctors. Some hospitals have banned vaginal deliveries after C-section, or VBAC. The VBAC rate has dropped to 9.2 percent of births after a previous Caesarean in 2004, compared with 28.3 percent in 1996.
The rate of Caesareans among women who have not previously had one has shot up, climbing to 20.6 percent of such births in 2004, compared with 19.1 percent in 2003 and 14.6 in 1996.
On the Net: C-section report: