Skip directly to searchSkip directly to the site navigationSkip directly to the page's main content

Complete Health Indicator Report of Cesarean Deliveries among Low Risk Women

Definition

The low-risk cesarean delivery rate is the percentage of cesarean deliveries among '''n'''ulliparous (first birth), '''t'''erm (37 completed weeks or more, based on the obstetric estimate), '''s'''ingleton (one fetus), '''v'''ertex (head first) births, sometimes referred to as NTSV births.

Numerator

Number of cesarean deliveries among nulliparous, full-term, singleton, vertex presentation (NTSV) births

Denominator

Total number of nulliparous, full-term, singleton, vertex presentation (NTSV) 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 women is a goal of the Healthy People 2020 initiative.

Healthy People Objective: Reduce cesarean births among low-risk (full-term, singleton, vertex presentation) women: Women with no prior cesarean births

U.S. Target: 23.9 percent
State Target: N/A - NJ objective is for women who have never given birth before. US objective is for women who have never had a c-section before.

Other Objectives

'''Healthy NJ 2020 Objective MCH-14 (NEW)''': Reduce cesarean births among low-risk (nulliparous, full-term, singleton, vertex presentation) women to 27.9% among the total population, 27.0% among Whites, 29.3% among Blacks, 27.6% among Hispanics, and 30.2% among Asians.

How Are We Doing?

The cesarean delivery rate among low risk New Jersey mothers declined in 2010 for the first time since the mid-1990s and in 2017 stood at 29.7% of births. The rate is slightly higher among Asian and Black (32%) mothers than among Hispanic (30%) and White (28%) mothers. It is also higher overall among foreign-born mothers than US-born mothers. Cesareans are performed more frequently among older mothers and among non-Medicaid recipients.

How Do We Compare With the U.S.?

The low-risk cesarean rate in New Jersey began to rise in 1995, two years ahead of the US rate, and rose more quickly than the national rate. Both rates peaked in 2009. Currently, the New Jersey low-risk cesarean rate is about 14% higher than the national rate.

What Is Being Done?

In 2017, a team composed of DOH staff and external partners [http://www.njha.com/njpqc/toolkits-and-resources/ntsv-c-section-reduction/ 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.

Available Services

C-Section Rates for New Jersey Hospitals: [https://nj.gov/health/fhs/maternalchild/outcomes/health-epidemiology/]


Related Indicators

Related Health Care System Factors Indicators:



Data Tables


Low-Risk Cesarean Deliveries by Year, New Jersey and the United States, 1990-2017 (HNJ2020)

US/NJYearPercentage of Low-Risk BirthsLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 56
US199021.6%
US199121.4%
US199221.0%
US199320.2%
US199419.1%
US199518.8%
US199618.5%
US199718.4%
US199818.7%
US199919.5%
US200020.3%
US200121.6%
US200223.1%
US200324.3%
US200425.7%
US200526.6%
US200627.1%
US200727.5%
US200827.8%
US200928.1%
US201027.6%
US201127.3%
US201227.3%
US201326.9%
US201426.0%
US201525.8%
US201625.7%
US201726.0%
NJ199023.5%23.0%23.9%8,88237,865
NJ199122.6%22.1%23.0%8,76338,847
NJ199222.4%22.0%22.8%8,53638,166
NJ199323.1%22.7%23.5%8,86438,397
NJ199422.0%21.6%22.4%8,48238,517
NJ199520.9%20.5%21.4%7,84237,465
NJ199621.4%21.0%21.8%8,10337,834
NJ199722.6%22.2%23.0%8,44337,394
NJ199823.2%22.8%23.6%8,65237,321
NJ199923.6%23.2%24.0%8,66236,688
NJ200025.1%24.6%25.5%9,55938,124
NJ200125.7%25.3%26.2%9,73537,866
NJ200227.9%27.4%28.3%10,43337,453
NJ200330.3%29.8%30.8%11,65338,468
NJ200432.3%31.8%32.8%12,16037,677
NJ200533.9%33.4%34.4%12,51336,919
NJ200634.6%34.1%35.1%12,88937,258
NJ200735.4%34.9%35.9%13,41537,903
NJ200835.3%34.8%35.8%13,13637,180
NJ200936.3%35.8%36.8%13,14436,163
NJ201034.9%34.4%35.4%12,27735,129
NJ201134.9%34.4%35.4%12,07234,586
NJ201235.1%34.6%35.6%11,91733,967
NJ201333.5%33.0%34.0%11,06933,066
NJ201432.4%31.9%32.9%10,64832,879
NJ201531.0%30.5%31.5%10,18032,828
NJ201630.4%30.0%30.9%10,52534,581
NJ201729.7%29.2%30.2%10,21034,399

Data Notes

This is Healthy New Jersey 2020 (HNJ2020) Objective MCH-14. Confidence intervals are not available for U.S. data.

Data Sources

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


Low-Risk Cesarean Deliveries by Year and Mother's Race/Ethnicity, New Jersey, 1990-2017 (HNJ2020)

Race/EthnicityYearPercentage of Low-Risk BirthsLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 112
White199024.1%23.6%24.7%5,83324,181
White199123.0%22.5%23.6%5,60724,330
White199222.7%22.2%23.2%5,33023,487
White199323.2%22.7%23.8%5,43823,439
White199422.3%21.7%22.8%5,15523,151
White199521.2%20.7%21.8%4,76122,414
White199621.6%21.0%22.1%4,78322,182
White199722.3%21.8%22.9%4,83221,668
White199822.8%22.2%23.4%4,82821,192
White199923.5%23.0%24.1%4,83520,544
White200024.8%24.2%25.4%5,17920,899
White200126.0%25.4%26.6%5,22520,107
White200228.9%28.3%29.5%5,66319,597
White200331.2%30.6%31.9%6,18619,797
White200433.0%32.3%33.7%6,23218,881
White200534.9%34.2%35.6%6,38418,290
White200635.7%35.0%36.4%6,38917,874
White200736.9%36.1%37.6%6,56017,801
White200835.8%35.1%36.6%6,13617,124
White200937.1%36.4%37.8%6,17016,625
White201034.8%34.1%35.6%5,70416,380
White201134.7%34.0%35.5%5,60416,137
White201234.9%34.2%35.7%5,40315,472
White201332.6%31.9%33.3%5,05515,509
White201431.4%30.7%32.2%4,81515,325
White201530.0%29.3%30.8%4,54715,133
White201629.3%28.6%30.0%4,64315,831
White201728.2%27.5%28.9%4,50715,970
Black199021.2%20.2%22.2%1,3706,454
Black199120.8%19.8%21.8%1,4506,978
Black199220.3%19.4%21.3%1,3566,665
Black199321.9%20.9%22.9%1,4736,735
Black199422.1%21.1%23.1%1,4946,767
Black199520.3%19.3%21.3%1,2396,101
Black199621.7%20.7%22.8%1,2935,952
Black199723.5%22.4%24.7%1,3375,679
Black199824.9%23.8%26.0%1,4275,739
Black199924.0%22.9%25.2%1,3235,507
Black200027.4%26.3%28.6%1,5255,560
Black200126.7%25.5%27.9%1,4695,509
Black200229.3%28.0%30.5%1,5745,380
Black200332.1%30.8%33.4%1,6755,217
Black200433.8%32.5%35.1%1,7305,114
Black200535.3%34.0%36.6%1,8495,232
Black200634.8%33.6%36.1%1,8565,328
Black200735.1%33.8%36.4%1,9475,546
Black200836.5%35.2%37.8%2,0375,583
Black200936.3%35.0%37.6%1,9615,397
Black201036.0%34.7%37.3%1,8735,208
Black201136.0%34.7%37.3%1,8225,059
Black201236.4%35.1%37.7%1,8615,112
Black201334.9%33.5%36.2%1,6434,711
Black201434.1%32.7%35.5%1,5364,504
Black201532.5%31.1%33.9%1,4084,331
Black201632.6%31.2%34.0%1,4184,347
Black201731.9%30.6%33.4%1,3544,238
Hispanic199023.4%22.3%24.5%1,3095,599
Hispanic199122.6%21.5%23.7%1,3285,881
Hispanic199223.3%22.2%24.4%1,3945,988
Hispanic199323.7%22.6%24.8%1,4546,142
Hispanic199421.8%20.8%22.9%1,4026,422
Hispanic199520.4%19.5%21.4%1,3346,525
Hispanic199621.0%20.1%22.0%1,4206,755
Hispanic199722.2%21.2%23.2%1,5206,843
Hispanic199823.2%22.3%24.3%1,6236,982
Hispanic199923.4%22.4%24.4%1,6537,069
Hispanic200024.6%23.7%25.6%1,8957,695
Hispanic200124.7%23.7%25.6%1,9848,041
Hispanic200225.4%24.5%26.4%2,1158,322
Hispanic200327.9%27.0%28.8%2,5099,000
Hispanic200430.3%29.3%31.2%2,8069,269
Hispanic200531.4%30.4%32.4%2,8529,083
Hispanic200632.8%31.8%33.7%3,1439,595
Hispanic200732.8%31.8%33.7%3,1939,748
Hispanic200832.5%31.6%33.4%3,0729,450
Hispanic200933.6%32.6%34.5%3,0809,180
Hispanic201033.5%32.5%34.5%2,8938,645
Hispanic201133.1%32.1%34.1%2,8098,491
Hispanic201233.7%32.7%34.8%2,7848,249
Hispanic201333.1%32.1%34.1%2,6518,011
Hispanic201432.2%31.2%33.2%2,5467,913
Hispanic201530.7%29.7%31.7%2,4698,048
Hispanic201629.7%28.7%30.7%2,4128,121
Hispanic201730.0%29.0%31.0%2,4318,114
Asian199023.8%21.6%26.2%3171,330
Asian199123.9%21.8%26.1%3641,525
Asian199222.3%20.4%24.2%4091,837
Asian199324.5%22.5%26.5%4461,824
Asian199420.4%18.6%22.3%3861,896
Asian199521.2%19.5%23.1%4472,105
Asian199621.1%19.6%22.7%5542,624
Asian199723.8%22.3%25.4%6902,897
Asian199822.7%21.2%24.2%6823,006
Asian199924.1%22.6%25.6%7683,191
Asian200024.4%23.0%25.8%9023,702
Asian200125.0%23.6%26.3%9873,955
Asian200226.0%24.6%27.4%1,0233,939
Asian200328.6%27.2%30.0%1,2134,243
Asian200431.1%29.7%32.5%1,3084,206
Asian200533.4%31.9%34.8%1,3724,113
Asian200633.8%32.4%35.2%1,4324,236
Asian200735.9%34.5%37.3%1,6084,480
Asian200837.7%36.3%39.1%1,7284,586
Asian200939.7%38.2%41.1%1,7404,384
Asian201037.4%36.0%38.9%1,6094,301
Asian201138.2%36.8%39.6%1,6704,373
Asian201236.8%35.4%38.2%1,6794,561
Asian201335.7%34.2%37.1%1,5064,223
Asian201434.3%32.9%35.7%1,4814,320
Asian201533.7%32.3%35.1%1,4274,235
Asian201633.4%32.0%34.7%1,6624,982
Asian201732.3%31.0%33.6%1,5564,813

Data Notes

This is Healthy New Jersey 2020 (HNJ2020) Objective MCH-14. 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


Low-Risk Cesarean Deliveries by Race/Ethnicity, New Jersey 2017

Race/EthnicityPercentage of Low-Risk BirthsLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 6
White28.2%27.5%28.9%4,50715,970
Black31.9%30.6%33.4%1,3544,238
Hispanic30.0%29.0%31.0%2,4318,114
Asian32.3%31.0%33.6%1,5564,813
New Jersey29.7%29.2%30.2%10,21034,399
United States26.0%

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


Low-Risk Cesarean Deliveries by Race/Ethnicity and Birth Place, New Jersey 2017

Birth PlaceRace/EthnicityPercentage of Live BirthsLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 15
U.S. States and D.C.White28.1%27.3%28.8%3,60312,844
U.S. States and D.C.Black31.0%29.4%32.7%9393,028
U.S. States and D.C.Hispanic30.7%29.2%32.3%1,0433,395
U.S. States and D.C.Asian28.9%25.1%33.0%153530
U.S. States and D.C.New Jersey28.8%28.2%29.5%5,89120,423
U.S. TerritoriesWhite**
U.S. TerritoriesBlack**
U.S. TerritoriesHispanic28.8%24.0%34.2%91316
U.S. TerritoriesAsian**
U.S. TerritoriesNew Jersey28.6%23.8%33.9%94329
Remainder of WorldWhite28.8%27.2%30.5%8753,038
Remainder of WorldBlack34.2%31.5%36.9%4091,195
Remainder of WorldHispanic29.4%28.1%30.8%1,2904,387
Remainder of WorldAsian32.8%31.4%34.2%1,4004,269
Remainder of WorldNew Jersey30.9%30.2%31.7%4,18213,515

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


Low-Risk Cesarean Deliveries by Maternal Age, New Jersey, 2017

Age GroupPercentage of Low-Risk BirthsLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 7
15-1713.9%11.2%17.2%77553
18-1919.9%18.0%22.0%3091,554
20-2421.3%20.4%22.3%1,4466,780
25-2927.6%26.7%28.5%2,7189,843
30-3432.0%31.1%32.9%3,46410,831
35-3942.5%40.9%44.0%1,6473,876
40-4458.3%54.8%61.7%462793

Data Source

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


Low-Risk Cesarean Deliveries by Year and Medicaid Status, New Jersey, 1997-2017

Medicaid StatusYearPercentage of Low-Risk BirthsLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 42
Medicaid199718.3%17.5%19.1%1,7279,440
Medicaid199820.4%19.6%21.2%1,9059,357
Medicaid199920.0%19.1%20.9%1,4757,385
Medicaid200021.3%20.4%22.3%1,6067,531
Medicaid200120.4%19.5%21.4%1,5207,435
Medicaid200223.7%22.8%24.6%1,9558,252
Medicaid200325.3%24.4%26.2%2,1818,622
Medicaid200428.2%27.3%29.1%2,5278,966
Medicaid200529.1%28.2%30.1%2,6038,936
Medicaid200630.5%29.5%31.4%2,7809,123
Medicaid200730.4%29.5%31.3%2,8819,482
Medicaid200829.7%28.8%30.7%2,7439,223
Medicaid200930.8%29.9%31.8%2,7568,938
Medicaid201029.9%29.0%30.8%2,7739,277
Medicaid201130.2%29.3%31.2%2,9279,678
Medicaid201231.7%30.8%32.6%3,1059,793
Medicaid201329.8%28.8%30.7%2,7179,126
Medicaid201430.4%29.4%31.4%2,5408,346
Medicaid201529.1%28.2%30.1%2,5488,752
Medicaid201627.1%26.2%28.0%2,3898,815
Medicaid201726.3%25.4%27.2%2,2698,634
Not Medicaid199724.1%23.6%24.6%6,40026,571
Not Medicaid199824.2%23.7%24.8%6,48926,769
Not Medicaid199924.7%24.2%25.2%6,89827,932
Not Medicaid200026.1%25.6%26.6%7,69629,509
Not Medicaid200127.1%26.6%27.6%7,94329,277
Not Medicaid200229.1%28.6%29.7%8,30728,516
Not Medicaid200331.9%31.3%32.4%9,21228,903
Not Medicaid200433.7%33.2%34.3%9,51828,222
Not Medicaid200535.5%34.9%36.1%9,73727,424
Not Medicaid200636.0%35.5%36.6%9,91727,524
Not Medicaid200737.2%36.6%37.8%10,28527,642
Not Medicaid200837.3%36.7%37.8%10,21427,401
Not Medicaid200938.3%37.7%38.8%10,19426,640
Not Medicaid201036.9%36.3%37.5%9,29425,161
Not Medicaid201136.8%36.2%37.4%8,97624,409
Not Medicaid201236.7%36.1%37.3%8,54023,261
Not Medicaid201335.1%34.5%35.7%8,07222,987
Not Medicaid201433.1%32.6%33.8%7,88123,775
Not Medicaid201531.8%31.2%32.4%7,59023,898
Not Medicaid201631.6%31.0%32.1%8,13125,751
Not Medicaid201730.8%30.2%31.4%7,93525,754

Data Source

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


Low-Risk Cesarean Deliveries by County, New Jersey, 2017

CountyPercentage of Low-Risk BirthsLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 23
Atlantic29.6%26.6%32.8%255861
Bergen34.5%32.9%36.1%1,1553,348
Burlington26.8%24.6%29.1%4151,549
Camden22.0%20.2%23.9%4251,935
Cape May38.5%32.4%44.5%95247
Cumberland21.6%18.2%25.4%114528
Essex30.9%29.4%32.5%1,0173,287
Gloucester22.9%20.3%25.7%222969
Hudson32.1%30.7%33.4%1,3914,340
Hunterdon23.4%19.0%28.4%78334
Mercer27.1%24.8%29.6%3731,374
Middlesex31.5%29.9%33.1%1,0543,344
Monmouth32.8%30.7%34.8%6431,963
Morris30.2%28.0%32.4%5181,715
Ocean21.8%20.1%23.6%4652,134
Passaic33.0%31.0%35.0%7152,167
Salem25.7%20.2%32.1%57222
Somerset28.9%26.3%31.7%3261,128
Sussex29.8%25.8%34.3%137459
Union29.7%27.8%31.6%6462,177
Warren34.3%29.1%39.5%109318
New Jersey29.7%29.2%30.2%10,21034,399
United States26.0%

Data Source

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

References and Community Resources

Curtin SC, Gregory KD, Korst LM, Uddin SFG. Maternal morbidity for vaginal and cesarean deliveries, according to previous cesarean history: New data from the birth certificate, 2013. National vital statistics reports; vol 64 no 4. Hyattsville, MD: National Center for Health Statistics. 2015. [https://www.cdc.gov/nchs/data/nvsr/nvsr64/nvsr64_04.pdf] Osterman MJK, Martin JA. Trends in low-risk cesarean delivery in the United States, 1990-2013. National vital statistics reports; vol 63 no 6. Hyattsville, MD: National Center for Health Statistics. 2014. [https://www.cdc.gov/nchs/data/nvsr/nvsr63/nvsr63_06.pdf] National Center for Health Statistics Method of Delivery Fast Stats: [https://www.cdc.gov/nchs/fastats/delivery.htm]

Page Content Updated On 05/24/2019, Published on 05/24/2019
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 Tue, 25 June 2019 8:39:28 from Department of Health, New Jersey State Health Assessment Data Web site: https://nj.gov/health/shad ".

Content updated: no date