Primary cesarean delivery rate increased from 2019 to 2021

The rate of primary cesarean deliveries decreased from 2016 to 2019 and then increased from 2019 to 2021, while the rate of repeat deliveries decreased during the same period, according to a July Vital Statistics Rapid Release report, a publication from the U.S. Centers for Disease Control and Prevention.

Michelle J.K. Osterman, M.H.S., from the National Center for Health Statistics in Hyattsville, Maryland, presents trends in primary and repeat cesarean delivery using data from all birth certificates registered to U.S. residents in the 50 states and District of Columbia.

Osterman found that from 2016 to 2019, the primary cesarean delivery rate fluctuated (21.6 to 21.9 percent) and then increased to 22.4 percent in 2021. In contrast, there was a less than 1 percent decrease in the repeat cesarean delivery rate each year, from 87.6 percent in 2016 to 85.9 percent in 2021. The primary cesarean delivery rate increased from 2019 to 2021 for women younger than 40 years, for most race and Hispanic-origin groups, and for all gestational age groups below 41 weeks. From 2019 to 2021, repeat cesarean delivery rates decreased for women aged 25 to 39 years, for non-Hispanic White and Hispanic women, and for those with gestational ages 39 to 41 weeks.

"The overall cesarean delivery rate, which is influenced by both the primary and repeat cesarean delivery rates, increased in both 2020 and 2021," the authors write. "This increase was driven by the increase in primary cesarean delivery and would have been greater if not for the continued decline in repeat cesarean deliveries during this period."

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