The Future of Cesarean Delivery Rates in the United States

被引：31
|
作者：
Clapp, Mark A. [1 ]
Barth, William H., Jr. [1 ]
机构：
[1] Harvard Med Sch, Massachusetts Gen Hosp, Boston, MA USA
来源：
CLINICAL OBSTETRICS AND GYNECOLOGY | 2017年 / 60卷 / 04期
关键词：
cesarean delivery rate; Robson classification; Nulliparous term singleton vertex (NTSV); Operative vaginal delivery; PREPREGNANCY OBESITY; BIRTH CENTERS; SECTION; OUTCOMES; RISK; CARE;
D O I：
10.1097/GRF.0000000000000325
中图分类号：
R71 [妇产科学];
学科分类号：
100211 ;
摘要：
The US cesarean delivery rate remains 30% 32%. Increases in maternal age, obesity, and diabetes put upward pressure on this rate. Alternatives to cesarean delivery, vaginal birth after cesarean (VBAC), and operative vaginal delivery, are underutilized and there are substantial challenges to their resurgence. Practice guidelines offer promise, but demonstrate onlyminor reductions in cesarean delivery. We estimate that the overall rate in theUS will remain 27%-30% for the immediate future. As more states move to recognize the independent practice of midwifery and more payers seek lower cost options for childbirth, we anticipate the overall rate will drop to 20% or 25%, but not for another 15 years or more.
引用
收藏
页码：829 / 839
页数：11
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