One goal of the national Healthy People 2020 initiative was to reduce the rate of first-time cesarean delivery (C-section) rates among first-time mothers with relatively low-risk pregnancies by 10% to 24.7%. Since it’s now officially 2020, journalists may want to look into how well the U.S., individual states, counties or hospitals are doing. The Healthy People 2020 goals include reducing the cesarean birth rate among women with low-risk pregnancies and a prior cesarean delivery.
When reporting on cesarean deliveries, it’s important to note the difference between primary (first-time) cesarean rates, repeat cesarean rates and overall rates. After one cesarean delivery, most women’s subsequent pregnancies also result in cesarean deliveries—the second Healthy People goal related to cesareans — so primary and overall numbers can differ meaningfully.
Another distinction to keep in mind is rate of “low-risk” pregnancies, another Healthy People focus. Low-risk pregnancies for primary cesarean rates are defined as those resulting in first-born, full-term infants (after at least 37 weeks of pregnancy) who are facing head-down and born by themselves (not twins or other multiples). The term for these births is nulliparous (the mother’s first pregnancy resulting in childbirth), (full-)term, singleton, vertex (head-first), or NTSV. Among those with previous pregnancies, low-risk is defined as full-term, downward-facing singleton births.
It can be challenging — sometimes impossible — to get more granular data on cesarean rates than state-level data. Some states and counties collect more specific data, but the collection varies geographically. The Leapfrog Group collects hospital-level data on cesarean rates, but it relies on voluntary reporting of NTSV rates, so reporters may need to call individual hospitals that did not report. The Leapfrog Group provides a page for searching and comparing hospitals, but journalists should contact the group directly to request complete data sets for an individual state or national hospital data.