The rate of caesarean-section deliveries performed in the U.S. reached a record high in 2004, despite efforts by the government to reduce the rate, according to data released on Tuesday by CDC's National Center for Health Statistics, the AP/Las Vegas Sun reports. Almost 1.2 million c-sections, or 29.1% of all births, were performed in the U.S. in 2004, which is an increase from 27.5% in 2003 and 20.7% in 1996. The government in 2000 introduced an agenda to reduce the rate of c-sections to 15% by 2010. The increase in the c-section rate can be attributed to patient and physician preference, physicians' fears of malpractice lawsuits over problems resulting from vaginal delivery and risks surrounding vaginal birth after c-section, according to the AP/Sun (Stobbe, AP/Las Vegas Sun, 11/16). Many physicians and hospitals will not allow VBACs because of malpractice and liability concerns. In addition, the American College of Obstetricians and Gynecologists in 1999 revised its guidelines to say that only hospitals with a surgical team immediately available should allow VBACs, spurring community hospitals to prohibit the procedure (Kaiser Daily Women's Health Policy Report, 8/24). The rate of VBACs has decreased 67% since 1996, accounting for 9.2% of births in 2004. A study released in December 2004 said 75% of VBACs observed were successful, with fewer than 1% of participants experiencing a uterine tear (Rubin, USA Today, 11/16).

Other Statistics
NCHS also reported other U.S. birth data from 2004.

• More than 500,000 infants were born prematurely in 2004. The rate of premature births has increased 18% since 1990, reaching 12.5% last year.



• The proportion of infants born with low birthweight increased from 7.9% in 2003 to 8.1% last year. The rate has increased 16% since 1990.



• 84% of pregnant women received prenatal care in their first trimester in 2004.



• 3.59% of pregnant women last year did not receive prenatal care until their final trimester or did not receive care at all.



• The proportion of pregnant women who smoked decreased from 10.4% in 2003 to 10.2% last year (USA Today, 11/16).