The cesarean delivery rate in the United States has risen from 5.5% in 1970 to reach its highest level yet of 31.8% in 2007. Thus, at 1.2 million surgeries per year, ce-sarean delivery is the most common major surgery performed, essentially twice the goal of 15% from Healthy People 2010. In addition, primary cesarean deliveries, which accounted for 20.6% of all deliveries in 2004, continue to climb, increasing by 5% annually, and it appears the old adage, once a cesarean, always a cesarean, is true for >90% of women. Because the rate of vaginal birth after cesarean (VBAC) has fallen to its lowest level in 20 years as well, this means that the overall rate of cesarean delivery is only likely to continue to rise.
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