title: Contemporary cesarean delivery practice in the United States.
abstract: OBJECTIVE
  To describe contemporary cesarean delivery practice in the United States.
  
  
  METHODS
  Consortium on Safe Labor collected detailed labor and delivery information from 228,668 electronic medical records from 19 hospitals across the United States, 2002-2008.
  
  
  RESULTS
  The overall cesarean delivery rate was 30.5%. The 31.2% of nulliparous women were delivered by cesarean section. Prelabor repeat cesarean delivery due to a previous uterine scar contributed 30.9% of all cesarean sections. The 28.8% of women with a uterine scar had a trial of labor and the success rate was 57.1%. The 43.8% women attempting vaginal delivery had induction. Half of cesarean for dystocia in induced labor were performed before 6 cm of cervical dilation.
  
  
  CONCLUSIONS
  To decrease cesarean delivery rate in the United States, reducing primary cesarean delivery is the key. Increasing vaginal birth after previous cesarean rate is urgently needed. Cesarean section for dystocia should be avoided before the active phase is established, particularly in nulliparous women and in induced labor.
authors: Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA.
authors: Jun
authors: J
authors: Zhang
authors: James
authors: J
authors: Troendle
authors: Uma M
authors: UM
authors: Reddy
authors: S Katherine
authors: SK
authors: Laughon
authors: D Ware
authors: DW
authors: Branch
authors: Ronald
authors: R
authors: Burkman
authors: Helain J
authors: HJ
authors: Landy
authors: Judith U
authors: JU
authors: Hibbard
authors: Shoshana
authors: S
authors: Haberman
authors: Mildred M
authors: MM
authors: Ramirez
authors: Jennifer L
authors: JL
authors: Bailit
authors: Matthew K
authors: MK
authors: Hoffman
authors: Kimberly D
authors: KD
authors: Gregory
authors: Victor H
authors: VH
authors: Gonzalez-Quintero
authors: Michelle
authors: M
authors: Kominiarek
authors: Lee A
authors: LA
authors: Learman
authors: Christos G
authors: CG
authors: Hatjis
authors: Paul
authors: P
authors: van Veldhuisen
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000706:statistics & numerical data*; D017604:Cesarean Section, Repeat / Q000706:statistics & numerical data; D002921:Cicatrix / Q000453:epidemiology; D016208:Databases, Factual; D004420:Dystocia / Q000453:epidemiology / Q000601:surgery; D005260:Female; D005316:Fetal Distress / Q000453:epidemiology; D005865:Gestational Age; D006801:Humans; D007746:Labor Presentation; D007747:Labor Stage, First; D007751:Labor, Induced / Q000706:statistics & numerical data; D008423:Maternal Age; D009765:Obesity / Q000453:epidemiology; D010298:Parity; D011247:Pregnancy; D011272:Pregnancy, Multiple; D014219:Trial of Labor; D014481:United States / Q000453:epidemiology