Astonishingly, while maternal health and safety has improved almost everywhere in the world since 1990, the situation in the United States has deteriorated significantly. The number of maternal deaths per 100,000 live births grew from 12 in 1990 to 28 in 2013. While that is still a good number compared to large parts of the world, there are 30 countries in the world with a maternal mortality ratio much lower than the United States. The increase in maternal deaths can be attributed to a number of reasons. For one, the average age and weight of women getting pregnant is rising, increasing the risks associated with pregnancy. Moreover, the number of c-section births is growing rapidly, as more and more women choose to give birth by c-section for cosmetic rather than medical reasons.