Indicator Profile of Cesarean Delivery
Why Is This Important?
The World Health Organization (WHO) defines normal birth as ". . . spontaneous in onset, low risk at the start of labor and remaining so throughout labor and delivery. The infant is born spontaneously in the vertex position between 37 and 42 completed weeks of pregnancy. After birth, mother and infant are in good condition." The aim of the care in normal birth is "to achieve a healthy mother and child with the least possible level of intervention that is compatible with safety. In normal birth, there should be a valid reason to interfere with the natural process."In 2006, nearly one-third (31%) of all children in the U.S. were born by Cesarean delivery. This represents a 50% increase over the past decade, from 20.7% in 1996. The increases are present in all age groups and for all races and ethnic origins, without identified concurrent sources of increased obstetrical risk. A controversial aspect of this discussion is Cesarean delivery on maternal request (CDMR) at term for a singleton pregnancy in the absence of any medical or obstetrical indication. It is not possible to obtain a confident estimate of the rate of CDMR at this time; however in 2009 data collection on this issue will commence.
The increase in Cesarean delivery is an issue of importance for all women, but even more so for first time mothers, as the trend is increasingly to schedule repeat Cesareans for all subsequent births, once a woman has had one Cesarean birth. This trend has implications not only for a woman's entire reproductive life, but also for infants and the entire health care system.
Since a Cesarean delivery entails major surgery for the mother, the following complications may occur (and occur often at a greater rate than for vaginal delivery): postpartum hemorrhage, infection, anesthetic complications, placental problems in subsequent pregnancies (including placenta previa and accreta), postpartum depression, and increased risk of surgical complications in the presence of maternal obesity. Effects of Cesarean delivery on the newborn may include difficulty with initiation of breastfeeding, prematurity, lacerations, and respiratory problems. Both mother and infant will experience longer and more costly hospital stays than after the normal vaginal delivery.
Rate of Primary Cesarean Among Low Risk Women Giving Birth for the First Time, Utah vs. U.S., 1998-2006
Data Sources
Utah Birth Certificate Database, Office of Vital Records and Statistics, Utah Department of Health; U.S. Center for Disease Control and Prevention, on-line data - CDC WONDER;Other Views
Definition
Delivery of infant from surgical incision into abdomen and through uterus (womb), rather than vaginal birthHow We Calculated the Rates
| Numerator: | Number of Cesarean deliveries for low risk women (giving birth for the first time, singleton pregnancy, vertex presentation, 37 weeks or greater gestation) |
| Denominator: | Number of live births to low risk women (giving birth for the first time with singleton pregnancy, vertex presentation at 37 weeks or greater gestation) |
Page Content Updated On 05/05/08,
Published on 05/07/08
