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 (nulliparous, full-term, singleton, and vertex presentation) women is a goal of the [https://health.gov/healthypeople/objectives-and-data/browse-objectives/pregnancy-and-childbirth/reduce-cesarean-births-among-low-risk-women-no-prior-births-mich-06 Healthy People 2030] initiative.

Definition

Proportion of live births by cesarean section

Data Sources

• Birth Certificate Database, Office of Vital Statistics and Registry, New Jersey Department of Health
  (https://www.nj.gov/health/vital/)
• National Vital Statistics Reports, National Center for Health Statistics, Centers for Disease Control and Prevention
  (https://www.cdc.gov/nchs/products/nvsr.htm)

How the Measure is Calculated

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 2022 stood at 32.8% of births. The cesarean delivery rate among White mothers has been significantly lower than among mothers of other racial/ethnic groups since 2013. The cesarean rate among Ocean County residents (19%, the lowest in the state) is half the rate among Passaic County residents (40%, the highest). The cesarean rate among [[a href="indicator/view/MODLowRisk.Year.html" low risk]] (nulliparous, 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]

More Resources

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]

Footnote References

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.