Attendant, Place and Timing, and Use of Obstetric Interventions of
U.S. Births Change Over Past Decade
For
Immediate Release:
December 2, 1999
Contact: NCHS Public Affairs
(301) 458-4800
E-mail: nchsquery@cdc.gov
Trends in the Attendant, Place and Timing of
Births and in the Use of Obstetric Interventions, United States, 1989-97. Vol. 47, No. 27.
16. pp. (PHS) 2000-1120. View/download PDF 287 KB
Midwives and Doctors of
Osteopathy were increasingly more likely to attend births; obstetric procedures, such as
electronic fetal monitoring increased substantially; induction of labor doubled, and
babies were more frequently delivered on weekdays--just a few of the changes in birth
patterns in the United States during the 1990s. The report also found that for the first
time in this decade, the rate of cesarean births increased slightly between 1996 and 1997
after a steady downward trend between 1989 and 1996.
Many of
the circumstances surrounding having a baby in the United States changed between 1989-1997
according to the newly released report, "Trends in the Attendant, Place and Timing of
Births, and in the Use of Obstetric Interventions: United States, 1989-97," from the
National Center for Health Statistics, Centers for Disease Control and Prevention. Drawing
data from birth certificates filed in state vital statistics offices and reported to the
NCHS, this report profiles the latest nationwide practices in birth and delivery as well
as variations by state.
Key
findings from the report show:
While the vast majority of
births in 1997 (92 percent) were attended by physicians, this proportion has declined
steadily as the percent of births attended by midwives has slowly increased to account for
7 percent of all births. For physician-attended births, the number attended by M.D's
dropped almost every year of the period while those attended by D.O's consistently
increased.
About 99 percent of
births were in hospitals, basically unchanged from 1989, but the percent of
out-of-hospital births that were in residences increased while those in freestanding
birthing centers declined.
While births were more
common on weekdays than on weekends in 1989, they have become even more concentrated on
weekdays since 1989. Births delivered by repeat cesarean and vaginal births that were
induced are especially likely to occur on weekdays. The single most popular day is
Tuesday. The most popular months to give birth continue to be July, August, and September.
The percent of mothers
receiving electronic fetal monitoring, ultrasound, induction, and stimulation all
increased over the period with the most dramatic increase being the doubling of the use of
induction of labor (from 9 percent in 1989 to 18 percent in 1997).
Between 1989 and 1996,
the rate of cesarean births dropped by 9 percent (from 22.8 per 100 births to 20.7) while
the rate of vaginal birth after a previous cesarean (VBAC) increased by 50 percent (from
18.9 per 100 women who have not had a previous cesarean to 28.3). However, the trends
appear to have changed between 1996 and 1997--the cesarean rate increased slightly while
the VBAC rate declined by 3 percent. The highest cesarean rate in 1997 was in Mississippi
(26.7) while the lowest was in Colorado (15.3).
The percent of births
that were delivered by forceps consistently declined during the period, from 5.5 to 2.8
percent of births, whereas the use of vacuum extraction consistently increased, from 3.5
to 6.2 percent.
Copies of the
report by Sally C. Curtin and Melissa M. Park are available from NCHS or can be viewed or
downloaded without charge from the NCHS website at www.cdc.gov/nchs.