The cesarean delivery rate in the United States has risen from 5.5% in 1970 to reach its highest level yet of 30.2% in 2005, despite a Healthy People 2010 goal of 15% for the primary cesarean delivery rate. In addition, primary cesarean deliveries, which accounted for 20.6% of all deliveries in 2004, continue to climb, increasing by 5% annually.4 At 1.2 million surgeries per year, cesarean delivery is the most common major surgery performed.One possible reason for the rise in the cesarean delivery rate is that there may simply be an increase in the need for cesarean deliveries. Several potential mechanisms that could contribute to the increasing need for indicated cesarean delivery are increasing birth weight and increasing maternal obesity and weight gain during pregnancy. Another possibility might be a rise in elective cesarean delivery by maternal request (CDMR.).
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