Preventing the first cesarean

摘要

We should all be concerned about the cesarean birth rate in the United States. The percentage of births via cesarean increased nearly 60% from 1996 to 2009 to an all-time high of 32.9%. There was a slight decline in the rate from 2009 to 2010 (to 32.8%) and no change from 2010 to 2011 (Hamilton, Martin, & Ventura, 2012). It is unclear what the ideal cesarean birth rate is, but nearly one out of three women having a cesarean is high. There are likely many contributing factors to the cesarean birth rate in the United States, some of which are amendable to change.Some experts believe that measurement and public reporting of institution and practitioner cesarean rates will promote change. In 2008, the National Quality Forum recommended measuring the rate of cesarean birth for low-risk nulliparous women at term with a singleton vertex fetus. In 2009, The Joint Commission (TJC) adopted this quality measure as part of their perinatal care measure set; starting in January 2014, all TJC-accredited hospitals with a birth volume of >l,100 births annually will be required to submit these data.