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Published on: June 6, 2020
Indications contributing to the increasing cesarean delivery rate
Emma L Barber1, Lisbet S Lundsberg, Kathleen Belanger
1From the Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale School of Medicine, New Haven, Connecticut; Center for Perinatal, Pediatric, and Environmental Epidemiology, Yale School of Public Health, New Haven, Connecticut.
Obstetrics and Gynecology
|June 8, 2011
Summary
Cesarean delivery rates rose significantly due to increased primary cesareans. Subjective indications like nonreassuring fetal status drove this rise more than objective factors.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Public Health
Background:
- Cesarean delivery rates have been increasing globally.
- Understanding the specific indications driving this trend is crucial for clinical practice and policy.
Purpose of the Study:
- To investigate physician-documented indications for cesarean delivery.
- To identify factors contributing to the rising cesarean delivery rate.
Main Methods:
- Analysis of 32,443 live births at an academic hospital (2003-2009).
- Examination of primary and repeat cesarean delivery rates and indications.
- Modeling of time trends for each indication to assess relative contributions to the cesarean rate increase.
Main Results:
- Cesarean delivery rate increased from 26% to 36.5% between 2003 and 2009.
- Primary cesarean deliveries accounted for 50% of this increase.
- Indications such as nonreassuring fetal status (32%), labor arrest (18%), and multiple gestation (16%) showed the largest increases.
Conclusions:
- Primary cesarean births are the main driver of the overall cesarean rate increase.
- Subjective indications (e.g., nonreassuring fetal status, arrest of dilation) contributed more significantly to the rise in primary cesareans than objective indications.
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