Cesarean delivery rate levels off

After rising steadily for nearly a decade, the rate of cesarean deliveries appears to have stabilized, according to a new report(www.cdc.gov/nchs/data/databriefs/db124.pdf) from the National Center for Health Statistics. New guidelines and policies encouraging longer gestations have led to a trend of cesarean deliveries occurring more frequently at 39 weeks than at 38 weeks.

The report looked at data from 1996 to 2011, during which time the rate of cesarean delivery for singleton pregnancies rose from 20.7% in 1996 to 32.9% in 2011, an increase of 60%. Cesarean deliveries accounted for 32.9% of all births in 2009, the high point for the procedure. The rate stabilized during 2010 and 2011 to 31.3% of all live births.

Looking at early and full-term births from 2009 to 2011, the researchers  found a slight decrease in cesarean deliveries at 37 weeks, from 33.1% to 32.8%. Cesarean delivery at 38 weeks saw a much larger decline during the same period, from 33.8% to 32.0%. However, the percentage of full-term cesarean deliveries at 39 weeks increased from 32.4% to 33.7%. Cesarean deliveries for 40-week term pregnancies remained unchanged.

A look at the demographics showed that cesarean deliveries for the same time period, 2009 to 2011, showed that delivery rates fell by at least 5% for all maternal age groups for 38-week deliveries. The largest decline was in women younger than 25, going from 26.5% to 24.7%. On the other hand, the rate of cesarean delivery at 39 weeks increased by at least 1% for every maternal age group, with a jump from 42.8% to 44.1% for women aged 35 or older. Cesarean deliveries at 38 weeks declined for all of the major racial and ethnic groups, by nearly 6% for non-Hispanic white women, and roughly 4% for non-Hispanic black women and Hispanic women. In contrast, the rate of cesarean deliveries at 39 weeks rose for every racial and ethnic group, increasing by 6% for Hispanic women, 4% for non-Hispanic black women, and nearly 3% for non-Hispanic white women.

To get weekly advice for today's Ob/Gyn, subscribe to the Contemporary Ob/Gyn Special Delivery.