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C-Section Rate Drops for First Time in a Decade in U.S.
Date:11/17/2011

By Steven Reinberg
HealthDay Reporter

THURSDAY, Nov. 17 (HealthDay News) -- For the first time in more than a decade, the rate of cesarean deliveries has dropped, a new U.S. government report shows.

Although the drop reported by the Centers for Disease Control and Prevention was small, from 32.9 percent in 2009 to 32.8 percent in 2010, experts say it is further evidence that the increase in cesarean births has finally leveled off.

"But with only one data point, we have to wait to see what the future holds before we can make any statements about trends," said report author Brady E. Hamilton, a statistician at the CDC's Division of Vital Statistics. "We have to wait and see what happens."

According to the CDC report, the teen birth rate has also dropped, to a record low. From 2009 to 2010 it fell 9 percent, to 34.3 births per 1,000 teen births.

That's the lowest rate ever recorded in almost 70 years of collecting data, the CDC report noted. Birth rates for younger and older teens, and for all racial and ethnic groups, reached historic lows in 2010, according to the report.

The rate of cesarean delivery had been rising for years because of doctor's concerns over possible complications and malpractice lawsuits.

However, many experts feel a full-term, vaginal birth is much better in terms of the infant's development, and recent guidelines issued by the American College of Obstetricians and Gynecologists recommend vaginal labor even for women who have had a previous cesarean delivery.

"I think the word is out that sections are riskier in the short term and in subsequent pregnancies for mom. That message is getting out to providers and directly to patients," said Dr. George A. Macones, head of the department of obstetrics and gynecology at Washington University School of Medicine in St. Louis. He is also chair of the Committee on Obstetric Practice at the American College of Obstetricians and Gynecologists.

"You are going to have cesarean rates that are going to be higher in children who present with complications," said Dr. Daniel Armstrong, chief administrative officer of Holtz Children's Hospital and a professor of pediatrics at the University of Miami Miller School of Medicine.

"The highest-risk deliveries are in teenage moms and you've got a big drop in teenage moms, and I suspect that cesarean sections are dropping because (a) they aren't needed, and (b) because you are having fewer high-risk births, because you are having fewer teenage pregnancies," he said.

In addition, the overall fertility rate in the United States dropped for the third year in a row.

The rate went from 66.2 births per 1,000 women aged 15 to 44 in 2009 to 64.1 per 1,000 women in 2010. And the total number of births dropped 3 percent, from about 4.1 million in 2009 to about 4 million in 2010, the researchers found.

Armstrong noted that this has been an ongoing trend ever since the baby boomer generation. "You had this big bump, and each generation after the baby boomers has been a smaller generation," he said.

Also, births to unmarried woman dropped for the second straight year, to roughly 1.6 million in 2010 from 1.7 million in 2009.

"We have a decline in all three measures of unmarried childbearing. That is the number of births, the proportion of births born to unwed mothers and the rate," Hamilton said.

And while the birth rate for woman in their early 20s dropped 6 percent and rates also fell for woman in their late 20s and early 30s, it continued to rise for woman in their early 40s.

In 2010, the birth rate for these women rose 2 percent, the highest rate since 1967, the report found. "More women are delaying birth," Hamilton said.

Younger women may be having fewer babies due to the economy, Hamilton explained, while older women are usually more settled and may not be as affected by economic factors.

"When you are in your 20s and the economy isn't particularly good, you can afford to wait a few years until things are better before having a child," he said.

More information

For more on U.S. births, visit the U.S. Centers for Disease Control and Prevention.

SOURCES: Brady E. Hamilton, Ph.D., statistician, Joyce A. Martin, M.P.H., epidemiologist, both of the Division of Vital Statistics, U.S. Centers for Disease Control and Prevention; George A. Macones, M.D., head, department of obstetrics and gynecology, the Elaine and Mitchell Yanow Professor, Washington University School of Medicine, St. Louis, and chair, Committee on Obstetric Practice, American College of Obstetricians and Gynecologists; Daniel Armstrong, M.D., chief administrative officer, Holtz Children's Hospital, and professor, pediatrics, University of Miami Miller School of Medicine; Nov. 17, 2011, Births: Preliminary Data for 2010


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