Skip directly to searchSkip directly to the site navigationSkip directly to the page's main content
Skip directly to searchSkip directly to the site navigationSkip directly to this page's context menuSkip directly to the page's main content
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). Data updated by Maternal and Child Health Epidemiology Unit (MCH-Epi), Section of Women's, Children's and Family Health in July 2019 [SAS analysis in June 2019] Birth certificate data updated by HAVRS on May 22, 2019.

Data Source

[http://dhss.alaska.gov/dph/VitalStats/Pages/default.aspx Health Analytics and Vital Records Section (HAVRS)], 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 for a specific time period.

Denominator

Total number of live births to maternal residents with low-risk pregnancies for a specific time period.

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?

After a period of steady increase in the proportion of cesarean deliveries (C-sections) among Alaska women with low-risk pregnancies culminating at 20.8% in 2006, there has been a recent decline to 16.7% in 2018. Although the statewide proportion has declined overall since 2006, the trend has not been consistent when looked at by region and other factors. During 2014-2018, the Southwestern and Northern Public Health Regions experienced the lowest rates of C-sections among women with low-risk pregnancies (7.7% and 9.8%, respectively). The proportion of C-sections among Alaska women with low-risk pregnancies increases with age. During 2014-2018, 45.3% of the women with low-risk pregnancies who were 40 years or older had cesarean deliveries while 8.0% under the age of 20 years had C-sections.

How Do We Compare With the U.S.?

In 2017, approximately 26.0% of women with low-risk pregnancies in the United States had cesarean deliveries compared to 19.2% of women in Alaska for the same year.^5^ 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).^6^[[br]] [[br]] ---- {{class.SmallerFont 5. Hamilton BE, Martin JA, Osterman MJK, Rossen LM. Births: Provisional data for 2018. Vital Statistics Rapid Release; no 7. Hyattsville, MD: National Center for Health Statistics. May 2019. [https://www.cdc.gov/nchs/data/vsrr/vsrr-007-508.pdf] Accessed July 19, 2019. 6. 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. [https://www.cdc.gov/nchs/data/nvsr/nvsr63/nvsr63_06.pdf] Accessed July 17, 2019. }}

What Is Being Done?

The Alaska Department of Health and Social Services, Division of Public Health, Section of Women's, Children's, and Family Health (WCFH) serves as the administrative partner to the Alaska Perinatal Quality Collaborative (AKPQC). Established in January 2019, the AKPQC advances data-driven initiatives that improve maternal and newborn care in Alaska. With statewide membership and a steering committee comprised of health care professional organizations, hospital clinicians and leadership, and public health professionals, the AKPQC is well-positioned to promote standardized maternal care across Alaska health care facilities with a focus on reducing unnecessary risky procedures and treatments.^7^ Many states have active PQCs, and they have used them to contribute to improvements in perinatal outcomes and collectively address issues related to maternal and newborn health. PQC members identify health care processes that need to be improved and use the best available methods to make changes as quickly as possible.^8^ [[br]] [[br]] ---- {{class .SmallerFont 7. Alaska State Hospital and Nursing Home Association. Alaska Perinatal Quality Collaborative. 2018.[https://www.ashnha.com/alaska-perinatal-quality-collaborative/]. Accessed on July 17, 2019. 8. Center for Disease Control and Prevention. Perinatal Quality Collaboratives. 2018.[https://www.cdc.gov/reproductivehealth/maternalinfanthealth/pqc.htm]. Accessed on July 17, 2019.}}
Page Content Updated On 08/13/2019, Published on 08/27/2019
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, 19 October 2019 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, 27 Aug 2019 10:25:36 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, 19 October 2019 18:55:58 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, 27 Aug 2019 10:25:36 AKDT