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Complete Health Indicator Report of Cesarean Deliveries

Definition

The method by which an infant is extracted from its mother

Numerator

Number of method-specific births

Denominator

Total number of live births

Why Is This Important?

Compared to vaginal deliveries, cesareans carry an increased risk of infection, blood clots, longer recovery, and difficulty with future pregnancies. Reducing cesarean births among low-risk (full-term, singleton, and vertex presentation) women is a goal of the Healthy People 2030 initiative.

How Are We Doing?

The cesarean delivery rate among New Jersey mothers declined in 2010 for the first time since the mid-1990s and in 2021 stood at 32.4% of births. The cesarean delivery rate among White mothers is significantly lower than among mothers of other racial/ethnic groups. The cesarean rate among Ocean County residents (the lowest in the state) is half the rate among Passaic County residents (the highest). The cesarean rate among [https://www-doh.state.nj.us/doh-shad/indicator/view/MODLowRisk.Year.html low risk] (full term, singleton, vertex presentation) deliveries is a few percentage points lower than for all deliveries but demographic and trend patterns remain the same.

How Do We Compare With the U.S.?

In the early 1990s, the cesarean rate in New Jersey began to exceed that of the nation as a whole and continued to rise more quickly than the national rate. The rate has slowly decreased in recent years and the New Jersey rate is once again about the same as the national rate.

What Is Being Done?

In 2017, a team composed of DOH staff and external partners collaborated to develop a plan to reduce low risk c-sections in New Jersey hospitals. In 2018, DOH awarded [https://nj.gov/health/news/2018/approved/20180711a.shtml $4.7 million] to eight agencies to improve health outcomes among infants and mothers in New Jersey, including implementation of a doula pilot program to reduce the likelihood of certain birth and delivery/labor outcomes such as cesarean births. In 2021, the state [https://nj.gov/governor/news/news/562021/approved/20210202b.shtml Medicaid program began covering doula care], while also no longer paying for non-medical early elective deliveries. The same year, the [http://nurturenj.nj.gov/wp-content/uploads/2021/01/20210120-Nurture-NJ-Strategic-Plan.pdf Nurture NJ Strategic Plan] recommended that all NJ birthing hospitals meet or attain low-risk cesarean birth rates lower than the national target by instituting new, comprehensive informed consent processes for all maternity patients so that patients understand the short- and long-term risks of c-sections and the benefits of spontaneous labor for both parents and newborns. The Plan also recommended more aggressive action by state government agencies to ensure improvement, including limitations on participation in provider networks for hospitals who do not meet targets.[http://nurturenj.nj.gov/wp-content/uploads/2021/01/20210120-Nurture-NJ-Strategic-Plan.pdf#page=61 ^1^]

Available Services

See Programs and Resources on [https://nj.gov/governor/admin/fl/nurturenj.shtml]


Related Indicators

Related Health Care System Factors Indicators:



Data Tables


Method of Delivery: Cesarean Deliveries by Year, New Jersey and the United States, 1990-2021

US/NJYearPercentage of Live BirthsLower LimitUpper LimitNumer- ator
Record Count: 64
US199022.7%
US199122.6%
US199222.3%
US199321.8%
US199421.2%
US199520.8%
US199620.7%
US199720.8%
US199821.2%
US199922.0%
US200022.9%
US200124.4%
US200226.1%
US200327.5%
US200429.1%
US200530.3%
US200631.1%
US200731.8%
US200832.3%
US200932.9%
US201032.8%
US201132.8%
US201232.8%
US201332.7%
US201432.2%
US201532.0%
US201631.9%
US201732.0%
US201831.9%
US201931.7%
US202031.8%
US202132.1%
NJ199023.3%23.1%23.5%28,679
NJ199122.6%22.3%22.8%27,443
NJ199222.8%22.6%23.0%27,481
NJ199323.4%23.1%23.6%27,563
NJ199422.6%22.3%22.8%26,605
NJ199522.1%21.9%22.4%25,477
NJ199622.9%22.7%23.2%26,227
NJ199723.9%23.6%24.1%27,031
NJ199824.6%24.4%24.8%28,011
NJ199925.3%25.1%25.6%28,803
NJ200026.5%26.2%26.7%30,569
NJ200127.9%27.7%28.2%32,326
NJ200230.0%29.7%30.2%34,364
NJ200332.1%31.8%32.4%37,495
NJ200433.9%33.6%34.2%38,796
NJ200535.2%34.9%35.5%40,020
NJ200636.3%36.0%36.6%41,597
NJ200736.9%36.6%37.2%42,771
NJ200837.3%37.0%37.6%41,952
NJ200938.1%37.8%38.4%41,778
NJ201037.4%37.2%37.7%39,903
NJ201137.9%37.6%38.2%39,988
NJ201237.6%37.3%37.8%38,973
NJ201337.0%36.7%37.3%37,890
NJ201436.2%35.9%36.5%37,209
NJ201535.3%35.0%35.6%36,123
NJ201636.2%35.9%36.5%37,111
NJ201735.9%35.6%36.2%36,347
NJ201834.9%34.6%35.2%35,318
NJ201933.8%33.5%34.1%33,537
NJ202033.2%32.9%33.5%32,248
NJ202132.4%32.1%32.7%32,856

Data Notes

Confidence intervals are not available for U.S. data.[[br]] The uptick in 2016 is due to more accurate reporting of NJ resident births that occur out of state.

Data Sources

  • Birth Certificate Database, Office of Vital Statistics and Registry, New Jersey Department of Health
  • National Vital Statistics System, National Center for Health Statistics (NCHS), Centers for Disease Control and Prevention (CDC), [https://www.cdc.gov/nchs/nvss/index.htm]


Method of Delivery by Year, New Jersey, 1990-2021

Method of DeliveryYearPercentage of Live BirthsNumer- ator
Record Count: 64
Vaginal199068.4%84,160
Vaginal199169.6%84,564
Vaginal199269.2%83,452
Vaginal199369.3%81,699
Vaginal199470.1%82,549
Vaginal199571.3%82,119
Vaginal199672.4%82,753
Vaginal199771.6%81,138
Vaginal199871.3%81,152
Vaginal199970.3%79,970
Vaginal200068.9%79,602
Vaginal200167.5%78,133
Vaginal200265.6%75,183
Vaginal200363.3%73,917
Vaginal200462.0%70,985
Vaginal200560.2%68,435
Vaginal200659.2%67,849
Vaginal200758.2%67,434
Vaginal200857.8%65,022
Vaginal200957.3%62,784
Vaginal201057.7%61,532
Vaginal201157.4%60,581
Vaginal201257.8%59,995
Vaginal201358.3%59,621
Vaginal201459.4%61,057
Vaginal201560.4%61,703
Vaginal201663.7%65,306
Vaginal201764.0%64,766
Vaginal201865.0%65,810
Vaginal201966.1%65,600
Vaginal202066.8%64,851
Vaginal202167.5%68,398
Cesarean199023.3%28,679
Cesarean199122.6%27,443
Cesarean199222.8%27,481
Cesarean199323.4%27,563
Cesarean199422.6%26,605
Cesarean199522.1%25,477
Cesarean199622.9%26,227
Cesarean199723.9%27,031
Cesarean199824.6%28,011
Cesarean199925.3%28,803
Cesarean200026.5%30,569
Cesarean200127.9%32,326
Cesarean200230.0%34,364
Cesarean200332.1%37,495
Cesarean200433.9%38,796
Cesarean200535.2%40,020
Cesarean200636.3%41,597
Cesarean200736.9%42,771
Cesarean200837.3%41,952
Cesarean200938.1%41,778
Cesarean201037.4%39,903
Cesarean201137.9%39,988
Cesarean201237.6%38,973
Cesarean201337.2%37,890
Cesarean201436.2%37,210
Cesarean201535.3%36,123
Cesarean201636.2%37,111
Cesarean201735.9%36,347
Cesarean201834.9%35,318
Cesarean201933.8%33,537
Cesarean202033.2%32,248
Cesarean202132.4%32,856

Data Notes

The uptick in both methods of delivery in 2016 is due to more accurate reporting of NJ resident births that occur out of state, resulting is fewer births with unknown method of delivery.

Data Source

Birth Certificate Database, Office of Vital Statistics and Registry, New Jersey Department of Health


Method of Delivery: Primary and Repeat Cesareans by Year, New Jersey, 1990-2021

Method of DeliveryYearRate per 100 at-risk birthsNumer- ator
Record Count: 64
Primary cesarean199017.5%17,412
Primary cesarean199116.8%16,575
Primary cesarean199217.1%16,580
Primary cesarean199317.6%16,834
Primary cesarean199417.0%16,351
Primary cesarean199516.7%15,747
Primary cesarean199617.6%16,467
Primary cesarean199718.3%16,983
Primary cesarean199819.0%17,866
Primary cesarean199919.4%18,138
Primary cesarean200020.3%19,236
Primary cesarean200121.1%20,039
Primary cesarean200222.8%21,451
Primary cesarean200324.7%23,459
Primary cesarean200426.0%24,294
Primary cesarean200526.9%24,552
Primary cesarean200627.8%25,570
Primary cesarean200728.1%25,838
Primary cesarean200828.3%25,103
Primary cesarean200928.7%24,744
Primary cesarean201027.9%23,265
Primary cesarean201128.2%23,146
Primary cesarean201227.8%22,438
Primary cesarean201326.8%21,184
Primary cesarean201425.7%20,475
Primary cesarean201526.0%21,014
Primary cesarean201625.8%21,940
Primary cesarean201724.7%20,597
Primary cesarean201823.4%19,454
Primary cesarean201922.4%18,248
Primary cesarean202022.1%17,651
Primary cesarean202121.5%18,043
Repeat cesarean199082.8%11,267
Repeat cesarean199180.9%10,868
Repeat cesarean199279.5%10,901
Repeat cesarean199378.6%10,729
Repeat cesarean199477.8%10,254
Repeat cesarean199573.1%9,730
Repeat cesarean199664.4%9,760
Repeat cesarean199765.8%10,048
Repeat cesarean199866.8%10,145
Repeat cesarean199970.1%10,665
Repeat cesarean200073.3%11,333
Repeat cesarean200178.9%12,287
Repeat cesarean200283.5%12,913
Repeat cesarean200386.1%14,036
Repeat cesarean200488.9%14,502
Repeat cesarean200590.8%15,468
Repeat cesarean200691.5%16,027
Repeat cesarean200792.3%16,933
Repeat cesarean200892.8%16,849
Repeat cesarean200992.7%17,034
Repeat cesarean201092.1%16,638
Repeat cesarean201191.5%16,842
Repeat cesarean201291.2%16,535
Repeat cesarean201390.3%16,706
Repeat cesarean201489.6%16,735
Repeat cesarean201588.5%15,109
Repeat cesarean201688.1%15,171
Repeat cesarean201788.3%15,750
Repeat cesarean201887.4%15,864
Repeat cesarean201986.2%15,289
Repeat cesarean202085.5%14,597
Repeat cesarean202184.9%14,813

Data Notes

Primary cesarean rate = cesarean deliveries per 100 births to women with no prior cesarean births[[br]] Repeat cesarean rate = cesarean deliveries per 100 births to women with a prior cesarean birth

Data Source

Birth Certificate Database, Office of Vital Statistics and Registry, New Jersey Department of Health


Method of Delivery: Cesarean Delivery Rate by Mother's Race/Ethnicity, New Jersey, 2021

Race/EthnicityPercentage of Live BirthsLower LimitUpper LimitNumer- ator
Record Count: 6
White29.8%29.3%30.2%13,853
Black36.9%36.0%37.7%4,698
Hispanic33.8%33.3%34.4%9,491
Asian34.8%33.9%35.8%3,542
New Jersey32.4%32.1%32.7%32,856
United States32.1%1,174,545

Data Notes

Data for White, Black, and Asian do not include Hispanics. Hispanic ethnicity includes persons of any race.

Data Source

Birth Certificate Database, Office of Vital Statistics and Registry, New Jersey Department of Health


Method of Delivery: Cesarean Delivery Rate by County of Residence, New Jersey, 2021

CountyPercentage of Live BirthsLower LimitUpper LimitNumer- ator
Record Count: 23
Atlantic35.1%33.3%36.9%960
Bergen36.0%35.0%37.0%3,284
Burlington29.8%28.5%31.2%1,382
Camden27.3%26.2%28.4%1,698
Cape May38.8%35.3%42.5%282
Cumberland30.3%28.2%32.5%534
Essex35.1%34.1%36.1%3,411
Gloucester32.1%30.4%33.8%974
Hudson35.4%34.4%36.4%3,226
Hunterdon32.2%29.3%35.1%337
Mercer31.1%29.7%32.5%1,271
Middlesex35.0%34.0%36.0%3,049
Monmouth31.3%30.1%32.4%1,914
Morris32.8%31.5%34.2%1,617
Ocean19.3%18.5%20.0%1,966
Passaic40.2%38.9%41.4%2,510
Salem32.6%29.2%36.2%233
Somerset34.3%32.7%36.0%1,087
Sussex34.8%32.3%37.4%476
Union34.8%33.7%36.0%2,296
Warren33.6%30.7%36.6%349
New Jersey32.4%32.1%32.7%32,856
United States32.1%1,174,545

Data Source

Birth Certificate Database, Office of Vital Statistics and Registry, New Jersey Department of Health

References and Community Resources

1. [http://nurturenj.nj.gov/wp-content/uploads/2021/01/20210120-Nurture-NJ-Strategic-Plan.pdf#page=61 Nurture NJ 2021 Strategic Plan], pages 61-62. C-section Rates for NJ Hospitals: [https://nj.gov/health/maternal/] National Center for Health Statistics Method of Delivery Fast Stats: [https://www.cdc.gov/nchs/fastats/delivery.htm]

Page Content Updated On 08/15/2023, Published on 08/15/2023
The information provided above is from the Department of Health's NJSHAD web site (https://nj.gov/health/shad). The information published on this website may be reproduced without permission. Please use the following citation: " Retrieved Thu, 28 March 2024 9:19:22 from Department of Health, New Jersey State Health Assessment Data Web site: https://nj.gov/health/shad ".

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