Health Indicator Report of Cesarean Deliveries among Low Risk Women
Compared to vaginal deliveries, cesareans carry an increased risk of infection, blood clots, longer recovery, and difficulty with future pregnancies.
NotesThis is Healthy New Jersey 2020 (HNJ2020) Objective MCH-14. Confidence intervals are not available for U.S. data.
- 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]
DefinitionThe 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.
NumeratorNumber of cesarean deliveries among nulliparous, full-term, singleton, vertex presentation (NTSV) births
DenominatorTotal number of nulliparous, full-term, singleton, vertex presentation (NTSV) births
Healthy People Objective: Reduce cesarean births among low-risk (full-term, singleton, vertex presentation) women: Women with no prior birthsU.S. Target: 24.7 percent
State Target: 27.9 percent
Other Objectives'''Healthy NJ 2020 Objective MCH-14''': 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 (NTSV) births declined in 2010 for the first time since the mid-1990s and in 2020 stood at 26.2%. The rate is higher among Asian (30.2%) and Black (29.9%) mothers than among Hispanic (25.8%) and White (24.4%) mothers. The Healthy New Jersey 2020 target for all low-risk mothers and for Whites, Hispanics, and Asians were achieved. If the current trend continues, the target for Blacks will also be achieved within a year or two.
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. 2020 was the first year in which New Jersey's rate was not statistically significantly higher than the US 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 [https://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 NTSV 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.[https://nurturenj.nj.gov/wp-content/uploads/2021/01/20210120-Nurture-NJ-Strategic-Plan.pdf#page=61 ^1^]
Available ServicesSee Programs and Resources on [https://nj.gov/governor/admin/fl/nurturenj.shtml]
Page Content Updated On 05/19/2022, Published on 05/19/2022