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C-Sections Continue 12-Year Climb: U.S. Report
Date:12/20/2010

By Amanda Gardner
HealthDay Reporter

MONDAY, Dec. 20 (HealthDay News) -- Continuing a 12-year climb, cesarean deliveries reached a record high in 2008, accounting for almost one-third of the births in the United States, a new report shows.

"Rates have been going up since 1996 across the board for all age groups and all ethnic groups," said Michelle Osterman, co-author of the study and an analyst with the National Center for Health Statistics. "The increase from year to year has been steadily declining since about 2002 and that's a good thing . . . but it's certainly not stopping."

Although cesarean delivery is clearly called for in certain cases (if the mother has preeclampsia or is diabetic), often it carries greater risks than vaginal delivery, Osterman said.

"Vaginal delivery should be preferred to cesarean, where the complication rate is way higher," said Dr. Mitchell Maiman, chairman of obstetrics and gynecology at Staten Island University Hospital in New York City. "And with [subsequent] C-sections, complications go dramatically higher, bleeding, hysterectomy, even death."

Reasons for the trend, which has increased 56 percent since 1996, range from mother preferences to doctors' fears of lawsuits, experts said.

Efforts to counteract the C-section boom have resulted in growing support for VBAC (vaginal birth after cesarean), whereby a mother is given the option of delivering vaginally, even though the previous birth was via C-section.

Meanwhile, the small baby boom seen earlier in the decade seems to have tapered off, with U.S. birth rates actually declining 2 percent between 2007 and 2008, to 4,251,095 births, according to the Annual Summary of Vital Statistics: 2008. The 2007 birth rate was the highest ever.

"I'm not surprised that birth rates are dropping in the U.S.," said Dr. Abdulla Al-Khan, section chief of maternal-fetal medicine and surgery at Hackensack
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