What is cesarean delivery (C-section)?

Updated: Dec 14, 2018
  • Author: Hedwige Saint Louis, MD, MPH, FACOG; Chief Editor: Christine Isaacs, MD  more...
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Answer

Cesarean delivery is defined as the delivery of a fetus through surgical incisions made through the abdominal wall (laparotomy) and the uterine wall (hysterotomy).

In 2014, 32.2% of women who gave birth in the United States did so by cesarean delivery. [1] The rapid increase in cesarean birth rates from 1996 to 2014 without clear evidence of concomitant decreases in maternal or neonatal morbidity or mortality raises significant concern that cesarean delivery is overused. The most common indications for primary cesarean delivery include labor dystocia, abnormal or indeterminate fetal heart rate tracing, fetal malpresentation, multiple gestation, and suspected fetal macrosomia. Safe reduction of the primary cesarean delivery rate will require different approaches for these indications, as well as others. Increasing women's access to nonmedical interventions during labor has also been shown to reduce cesarean birth rates. External cephalic version for breech presentation and a trial of labor for women with twin gestations when the first twin is in cephalic presentation are examples of interventions that can help to safely lower the primary cesarean delivery rate. [2] A practice bulletin from the American College of Obstetricians and Gynecologists (ACOG) recommends that all eligible women with breech presentations who are near term should be offered external cephalic version (ECV) to decrease the overall rate of cesarean delivery. [3, 4]


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