Why Did the C-section Rate in the United States Increase From Ten Percent to Thirty Percent Over the Last Fifty Years?

C-section rates in the United States increased dramatically from ten percent to thirty percent over the last fifty years. Different drivers explain the three X increase. Pregnancies are higher risk than they used to be. An increase in maternal obesity has raised the number of larger fetuses or cases where labor does not progress normally. The switch to continuous fetal monitoring during the active phase of labor in most hospitals leads to more C-sections when the tracing is not reassuring.

Once a patient has one C-section, the patient is more likely to have another one. Multiple C-sections increase the risk for abnormal placentation in the next pregnancy. The specific issue is placenta accreta spectrum where the placenta invades abnormally into the uterus during pregnancy and the placenta does not come out after the baby.

A lot of focus exists on trying to decrease the number or avoid any further increase.