As in many other countries, rates of cesarean delivery in the United States have increased over the past few decades. Whereas there were 208 cesarean deliveries per 1,000 live births in the U.S. in 1997, there were 319 such procedures per 1,000 live births in 2018. Rates of cesarean deliveries in the U.S. are higher among non-Hispanic black women than other races and ethnicities and are more common among older mothers. The state of Mississippi has the highest rate of cesarean deliveries in the U.S., with around 38 percent of all live births being delivered by c-section.
Some have speculated that one of the reasons for the increase in c-sections in many parts of the world, and in particular the United States, is financial. In California, for example, the average cost for a vaginal birth with insurance in 2017 was estimated to be almost 8,000 dollars, while the cost of a c-section with insurance was just over 11,000 dollars. Without health insurance, a c-section in California could cost as much as 19,000 dollars. However, financial incentives alone are not enough to explain the rise in cesarean sections around the globe. Such increases are most likely the result of a combination of factors which include, but are not limited to, the shorter time a c-section takes compared to a vaginal birth, safeguarding legal responsibility of the doctor and hospital, technology, and women becoming pregnant later in life.