Cesarean sections in North Carolina, 1988-1993

              A Special Report Series by
THE STATE CENTER FOR HEALTH AND ENVIRONMENTAL STATISTICS
P.O. Box 29538, Raleigh, N.C. 27626-0538
No. 96 August 1995
CESAREAN SECTIONS IN NORTH CAROLINA, 1988-1993
by ' > .
Kathryn B. McLawhorn
ABSTRACT
AUG 31 1995
RC. STATE LIBRARY
RALBGH
Cesarean sections are the most frequently performed surgical operation in the United States
(Elson, 1994). The inclusion ofmethod of delivery on North Carolina's birth certificate in 1988 allows
the examination of trends in cesarean section rates during the 6-year period 1988-1993. This study
includes an analysis ofmany birth characteristics and their relationship to method of delivery . Cesarean
sections in this report include primary and repeat.
A cesarean section involves an incision through the abdominal and uterine walls for delivery of
the infant and the placenta. Physicians perform this surgery for four common reasons: previous
cesarean, dystocia (abnormal progress of labor), breech position (feet or buttocks positioned to come
out first), and fetal distress (e.g., insufficient oxygen, unstable heart rate). In 1988, when method of
delivery was first reported on North Carolina birth certificates, the cesarean section rate was 25.1
percent. In 1993, this rate had dropped slightly to 22.4. The highest numbers of cesarean sections
occurred to women who were white, married, ages 25-29, had a high school education, and had single
babies with normal birthweights (similar to the pattern for all live births). Groups with the highest
percentage of live births delivered by cesarean section were whites, ages 40 and older, those with
college education or beyond, and those having babies weighing less than 1500 grams.
Although cesarean sections are commonly performed, literature about them suggests that they
often are performed unnecessarily. In addition to examining the data on current trends and character-istics,
this report also discusses the increasing influence that VBAC (vaginal birth after previous
cesarean delivery) and other factors have had on efforts to reduce overall cesarean rates.
_4E»A NORTH CAROLINA DEPARTMENT OF ENVIRONMENT. HEALTH, AND NATURAL RESOURCES
DEHIMR