Contemporary cesarean delivery practice in the united states
Open accessAbstract
Objective To describe contemporary cesarean delivery practice in the United States.Study design Consortium on Safe Labor collected detailed labor and delivery information from 228,668 electronic medical records from 19 hospitals across the United States, 2002-2008.Results The overall cesarean delivery rate was 30.5%. The 31.2% of nulliparous women were delivered by cesarean section. Prelabor repeat cesarean delivery due to a previous uterine scar contributed 30.9% of all cesarean sections. The 28.8% of women with a uterine scar had a trial of labor and the success rate was 57.1%. The 43.8% women attempting vaginal delivery had induction. Half of cesarean for dystocia in induced labor were performed before 6 cm of cervical dilation.Conclusion To decrease cesarean delivery rate in the United States, reducing primary cesarean delivery is the key. Increasing vaginal birth after previous cesarean rate is urgently needed. Cesarean section for dystocia should be avoided before the active phase is established, particularly in nulliparous women and in induced labor.
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Enrollment criteria targeting seemingly healthy pregnancy increased the ability to observe spontaneously initiated birth, with a lower induction/pre-labor cesarean rate than the U.S. overall.
“our enrollment criteria, which targeted seemingly healthy pregnancy, did increase our ability to observe spontaneously-initiated birth, as the rate of induction of labor/pre-labor cesarean was 40% in our sample compared to an overall U.S. rate of greater than 50% (Laughon et al., 2012; Zhang et al., 2010).”
From Childhood stress and birth timing among African American women: cortisol as biological mediator (2017) · cites this paper as Zhang et al., 2010
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References 37 · Cited by 576
- Authors
- Zhang, J., Troendle, J., Reddy, U. M., Laughon, S. K., Branch, D. W., Burkman, R., Landy, H. J., Hibbard, J. U., Haberman, S., Ramirez, M. M., Bailit, J. L., Hoffman, M. K., Gregory, K. D., Gonzalez-Quintero, V. H., Kominiarek, M., Learman, L. A., Hatjis, C. G., & van Veldhuisen, P.
- Affiliations
- National Institutes of Health (US)
- Intermountain Healthcare (US)
- Baystate Medical Center (US)
- MedStar Georgetown University Hospital (US)
- University of Illinois Chicago (US)
- Maimonides Medical Center (US)
- The University of Texas Health Science Center at Houston (US)
- MetroHealth Medical Center (US)
- Christiana Care Health System (US)
- Cedars-Sinai Medical Center (US)
- Indiana University Health (US)
- Summa Health System (US)
- ORCID
- Venue
- American Journal of Obstetrics and Gynecology
- Publisher
- Elsevier BV
- Published
- 2010-10
- Volume
- 203
- Issue
- 4
- Pages
- 326.e1-326.e10
- ISSN
- 0002-9378 (ISSN-L)
- PMC
- PMC2947574
- OpenAlex
- W2143472466
- Cited by
- 576
- References
- 37
- Citations by year
- 2026: 9 · 2025: 12 · 2024: 21 · 2023: 35 · 2022: 25 · 2021: 30 · 2020: 46 · 2019: 41 · 2018: 45 · 2017: 53 · 2016: 34 · 2015: 42 · 2014: 42 · 2013: 56 · 2012: 51
- FWCI
- 61.06
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- American Journal of Obstetrics and Gynecology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (HHSN267200603425C, ZIAHD008794)
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Health and Contraception
- Health Sciences › Medicine › Surgery › Anesthesia and Pain Management
- Keywords
- cesarean section, cesarean section rate, repeat cesarean section, uterine scar, trial of labor, vaginal birth after cesarean, labor induction, dystocia, nulliparous women, active phase of labor, primary cesarean delivery
- MeSH terms
- Adult, Cesarean Section, Cicatrix, Dystocia, Female, Fetal Distress, Gestational Age, Humans, Labor Presentation, Labor Stage, First, Labor, Induced, Maternal Age, Obesity, Parity, Pregnancy, Pregnancy, Multiple, Trial of Labor, United States, Databases, Factual, Cesarean Section, Repeat
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