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Am Fam Physician. 2005;71(9):1820

Cesarean and Vaginal Birth After Previous Cesarean Delivery

Data from the National Center for Health Statistics on the total and primary cesarean rates and vaginal birth after previous cesarean delivery (VBAC) rate in the United States from 1989 to 2003 were published in the January 21, 2005, recommendations and reports series of Morbidity and Mortality Weekly Report.

Preliminary data from 2003 indicated that 27.6 percent of all U.S. births resulted from cesarean deliveries, representing the highest percentage ever reported in the United States and a 6 percent increase from 2002. The total cesarean delivery rate and the primary cesarean delivery rate (i.e., percentage among women with no previous cesarean delivery) have increased every year since 1997 after declines during 1989 to 1996. The rate of VBAC decreased by 63 percent to 10.6 percent in 2003, after increasing from 1989 to 1996. Among women with previous cesarean deliveries, the likelihood of future cesarean deliveries was approximately 90 percent in 2003. The accompanying figure shows the trends in rates of VBAC, total cesarean deliveries, and primary cesarean deliveries from 1989 to 2003.

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