The C-Section Generation

One-third of American babies are now born by Cesarean section, versus 5 percent in 1970. Nell Lake explores the reasons and risks involved:

Demographic changes and shifts in maternal health may have contributed to the rise in the use of C-sections in recent decades. Pregnant women, overall, have become older and heavier, and older, heavier women undergo more C-sections. But such factors don’t account for all the differences shown in Ecker’s study, which sought to control for them by looking only at pregnancies that had progressed well: in which fetuses had reached full term, were normal weights, and in which labor had begun spontaneously (i.e., doctors had found no reason to induce labor early). Even among these cases, hospitals varied significantly in the frequency of C-sections. Such disparities matter because cesareans are expensive—on average, a cesarean costs about $20,000, a vaginal birth about $11,500—and also carry significant risks.

The main reason for the rise:

In a dynamic that is repeated in other medical care, doctors perform cesareans, in part, because they aren’t trained to favor or perform less-invasive techniques. With inadequate training and experience, liabilities and patients’ risk increase.