Differences in Cesarean Delivery Rates for Puerto Rican Mothers in Puerto Rico and the U.S. Mainland, 2023

This report explores differences between cesarean delivery rates for Puerto Rican mothers giving birth in Puerto Rico and the U.S. mainland in 2023, by maternal age, gestational age, source of payment for the delivery, and state.

This report uses data from the National Vital Statistics System natality data file. Information for Puerto Rico is based on data from birth certificates and includes all births occurring in Puerto Rico to residents of Puerto Rico who self-reported Puerto Rican ethnicity with known method of delivery (17,547 births in 2023). Information for the U.S. mainland is based on data for births occurring in the 50 states and District of Columbia (D.C.) to residents of the 50 states and D.C. who self-reported Puerto Rican ethnicity (1.8% of U.S. births in 2023) with known method of delivery (66,186 births in 2023).

The cesarean delivery rate among Puerto Rican mothers in Puerto Rico was 50.9% in 2023, 51% higher than that for Puerto Rican mothers in the U.S. mainland, 33.8%. Cesarean delivery rates for Puerto Rican mothers in Puerto Rico were higher than rates for Puerto Rican mothers in the U.S. mainland for all maternal age groups, all gestational ages except early preterm, all sources of payment for the delivery (private insurance, Medicaid, and self-pay), and all states with statistically reliable data and D.C.