Caesarean operations, in which an infant is extracted from the womb of its mother through an incision in her stomach, have been performed since ancient times. Originally used as a means of saving an unborn child whose mother was dying or dead, modern Caesareans assist mothers who are unable to deliver vaginally for any number of reasons. Once rare, Caesarean sections are now performed so frequently that they have become commonplace.
General U.S. Caesarean Rates
According to a 2010 report released by the CDC, in 2007, 32 percent of all women who gave birth in the U.S. did so by Caesarean section. Since 1996, Caesarean rates have risen in the United States, regardless of race, socioeconomic status, maternal age or infant gestational age. The most significant shift occurred between 2000 and 2007, where Caesarean rates increased by 37 percent.
Caesarean Rates by Age
In 2007, the Caesarean rate of mothers between the ages of 45 and 54 was 48 percent. Mothers between the ages of 35 and 39 had a rate of 42 percent; those between the ages of 30 and 34 had a rate of 36 percent; those between the ages of 25 and 29 had a 31 percent rate; those ages 20 to 24 had a 27 percent rate, and those under 20 had a 23 percent rate.
Caesarean Rates by Race and Ethnicity
Among races and ethnicities, in 2007 black non-Hispanics had the highest Caesarean rate at 34 percent. Non-Hispanic whites had a rate of 32 percent, Asians had a rate of 31 percent, Hispanics had a rate of 30 percent and American Indians and Alaskan natives had the lowest rate of C-sections at 28 percent.
Caesarean Rates by Gestational Age
In 2007, nearly 50 percent of infants of a gestational age of less than 34 weeks were delivered by C-section. Those of a 34- to 36-week gestational age had a Caesarean delivery rate slightly above 30 percent, and those those born at a gestational age of 37 weeks or higher had a Caesarean rate of about 25 percent.
Causes
Many factors account for the high rate of Caesarean sections. The birth rate among older mothers in the United States has increased, and older mothers have higher odds of needing a C-section. An increase in in-vitro fertilization has led to an increase in multiple births, which require Caesarean deliveries more often than single-baby births. Due to a fear of lawsuits, doctors are opting for emergency Caesarean sections more often and earlier in the labor process. In addition, many hospitals actively discourage women who have had previous C-sections from having vaginal births.
Concerns
Like any surgery, Caesareans carry inherent risks, such as hemorrhaging, anesthesia-related emergencies, blood clots and infections. Specifically, C-sections carry higher risks of fetal injury, maternal infection and maternal and fetal death than vaginal births, and women who have C-sections are at higher risk for placenta previa, stillbirth, low birth weight, uterine rupture and hysterectomies in future pregnancies, according to an article by Judith A. Lothian for the National Health Institutes. There is debate among medical experts about the high rate of Caesarean sections, their medical necessity and increased risk they pose to mothers and infants.
Concerns
References
- Centers for Disease Control and Prevention: Recent Trends in Caesarean Delivery in the United States
- MedlinePlus.com: C-Section
- US News: Health: Caesarean Rates Reach Record High
- New York Times: Caesarean Births Are at a High in U.S.
- National Insitutes of Health: National Library of Medicine: Caesarean Section History
- National Insitutes of Health: National Library of Medicine: The Caesarean Catastrophe
