Cesarean delivery is a surgical procedure that involves delivering a baby through an abdominal incision (laparotomy) and a uterine incision (hysterotomy). The first documented cesarean operation occurred in AD 1020, and the procedure has since evolved significantly. Today, cesarean delivery is the most common surgery performed in the United States, with over 1 million women undergoing cesarean deliveries annually.
The cesarean delivery rate increased from 5% in 1970 to 31.9% in 2016. This sharp increase can be attributed to various factors, including changes in maternal age, medical advancements allowing more complicated pregnancies to proceed, and evolving obstetric practices. In 2022, the United States recorded more than 3.66 million births, most of which resulted from spontaneous or induced labor. Labor dystocia remains the most common indication for primary cesarean delivery. Globally, cesarean delivery rates continue to rise, and reducing unnecessary cesarean procedures remains a priority in the United States, where 32.2% of all births in 2022 were cesarean deliveries.
Despite ongoing efforts to reduce the cesarean rate through initiatives such as promoting vaginal births after cesarean and encouraging natural labor when safe, experts predict that a significant decrease is unlikely for at least another decade. While the procedure carries both immediate and long-term risks, for some women, cesarean delivery may be the safest or even the only option for delivering a healthy newborn.
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