Litigation concerns on the part of doctors may be driving the trend towards C-sections, as well. Many obstetricians fear being sued should something go wrong in a vaginal delivery, the researchers noted.
"To make a significant impact on the high cesarean delivery rate in the United States, the focus should be preventing unnecessary primary cesarean deliveries from several aspects," the researchers wrote.
First, there needs to be fewer induced deliveries, and performing a C-section in cases of problem birth should not be done before the start of labor -- especially in women having their first child, the researchers said.
Vaginal delivery after an earlier cesarean should be encouraged, if possible, and there needs to be an accepted standard among physicians that indicates when a cesarean is needed, they added.
"Finally, increasing access to, and patient education on, trial of labor in women with a previous uterine scar and improving the [delivery] success rate are urgently needed," the researchers said.
Zhang noted that one limitation of the study is that the sample the researchers used is not necessarily representative of the United States as a whole, since much of the data came from teaching hospitals, which tend to see more complicated pregnancies than community hospitals.
For his part, Yasin said he wasn't surprised by the findings.
"That's the way things are," he said. "We are inducing labor more than we should. We are not being patient with or giving adequate time for women who are in labor. We are intervening before giving the patient every chance possible."
For more information on pregnancy, visit the U.S. National Institutes of Health.
SOURCES: Salih Yasin, M.D., associate professor, obstetrics and gynecology, Univer
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