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State of Alaska

Health Indicator Report of Cesarean Deliveries Among Low-Risk Pregnancies

For most low-risk pregnancies, cesarean delivery (C-section) carries a higher risk of maternal complications (e.g., infection, hemorrhage) and death than vaginal birth.^1^ Even without complications, women who have a C-section need more time and special care to heal than women who deliver vaginally. Women undergoing primary elective cesarean delivery incur greater morbidity over their reproductive lives.^2^ This includes uterine rupture, placenta previa, and other placental malformations.^3^ Among low-risk pregnancies, infants delivered by cesarean have higher rates of injury during delivery and neonatal mortality when compared to infants delivered vaginally.^4^[[br]] [[br]] ---- {{class.SmallerFont 1. Safe prevention of the primary cesarean delivery. Obstetric Care Consensus No. 1. American College of Obstetricians and Gynecologists. Obstet Gynecol 2014;123:693-711. 2. Miller ES, Hahn K, Grobman WA. Consequences of a primary elective cesarean delivery across the reproductive life. Obstetrics & Gynecology 2013;121(4):789-797. 3. Scott JR, Porter TF. Cesarean delivery. In: Gibbs RS, et al, eds. Danforth's Obstetrics and Gynecology. 10th ed. Philadelphia: Lippincott Williams and Wilkins; 2008. 4. MacDorman MF, Declercq E, Menacker F, Malloy MH. Infant and neonatal mortality for primary cesarean and vaginal births to women with "no indicated risk," United States, 1998-2001 birth cohorts. Birth 2006;33(3):175-182. }}

Notes

Full-term (37 or more weeks of gestation) for Alaska residents is based upon the obstetrical estimate of gestation at delivery (OE). [Dataset created 10/31/2017].   Region is determined by maternal residence, not site of delivery. [SAS analysis in Dec 2017]

Data Source

[http://dhss.alaska.gov/dph/VitalStats/Pages/default.aspx Alaska Health Analytics and Vital Records], Division of Public Health, Alaska Department of Health and Social Services

Definition

Percentage of cesarean deliveries among live births to maternal residents with low-risk pregnancies. A low-risk pregnancy is defined as nulliparous, full-term, singleton, and vertex-presentation (NTSV).

Numerator

Total number of cesarean deliveries among maternal residents with low-risk pregnancies.

Denominator

Total number of live births to maternal residents with low-risk pregnancies.

Healthy People Objective: Reduce cesarean births among low-risk women with no prior cesarean births.

U.S. Target: 23.9 percent

How Are We Doing?

Overall, C-sections among women with low-risk pregnancies in Alaska increased slowly from 16.4% in 1996 to 19.1% in 2016. The increase occurred in all age groups. The prevalence of C-sections among Alaska women with low-risk pregnancies rises with age. In 2016, half of the women with low-risk pregnancies who were 40 years or older had cesarean deliveries while just 1 in 10 women under the age of 20 years had C-sections. During 2014-2016, Alaska Native women with low-risk pregnancies had the lowest prevalence of C-sections in the state (12.2%) compared to women of other races. C-sections were most common among Black women (32.2%). Cesarean deliveries among low-risk pregnancies have increased in all 7 public health regions of Alaska since the five year period 1996-2000; the smallest percent increase occurred in the Mat-Su region (3%) while the largest occurred in Anchorage (52%). The Northern and Southwestern regions had the lowest rates of C-sections among women with low-risk pregnancies (9.5% and 8.4%, respectively) during the 5-year period, 2011-2016. Anchorage and the Southeastern region showed the highest rates during the same period of time (23.5% and 23.0%, respectively).

How Do We Compare With the U.S.?

In 2016, approximately 25.7% of women with low-risk pregnancies in the United States had cesarean deliveries compared to 19.1% of women in Alaska for the same year. In 2013, Alaska had the seventh lowest cesarean delivery rate among low-risk pregnancies in the nation (behind Utah, New Mexico, Hawaii, Idaho, South Dakota, and Colorado).^5^[[br]] [[br]] ---- {{class.SmallerFont 5. Osterman MJK, Martin JA. Trends in low-risk cesarean delivery in the United States 1990-2013. Natl Vital Stat Rep 2014;63(6):1-16. }}
Page Content Updated On 04/24/2018, Published on 04/24/2018
The information provided above is from the Alaska Department of Health and Social Services' Center for Health Data and Statistics, Alaska Indicator-Based Information System for Public Health (Ak-IBIS) web site (http://ibis.dhss.alaska.gov). The information published on this website may be reproduced without permission. Please use the following citation: " Retrieved Sat, 22 September 2018 from Alaska Department of Health and Social Services, Center for Health Data and Statistics, Alaska Indicator-Based Information System for Public Health web site: http://ibis.dhss.alaska.gov ".

Content updated: Tue, 24 Apr 2018 02:53:55 AKDT
The information provided above is from the Alaska Department of Health and Social Services' Center for Health Data and Statistics AK-IBIS web site (http://ibis.dhss.alaska.gov/). The information published on this website may be reproduced without permission. Please use the following citation: " Retrieved Sat, 22 September 2018 2:48:06 from Alaska Department of Health and Social Services, Center for Health Data and Statistics, Indicator-Based Information System for Public Health Web site: http://ibis.dhss.alaska.gov/ ".

Content updated: Tue, 24 Apr 2018 02:53:55 AKDT