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Low-Risk Cesarean Delivery, 2019 Health Of Women And Children Report
Measure: Low-risk Cesarean Delivery, 2019 Health Of Women And Children Report

Why does this matter?

In 2019, nearly one-third of births were delivered by cesarean (c-section), a surgical procedure that removes the baby through an incision in the woman’s abdomen. Some women with no medical need for a c-section elect to deliver via c-section. Elective c-sections are not recommended by the American Council of Gynecologists and Obstetricians (ACOG). Variations in practice patterns among hospitals nationwide may be one of the driving forces behind the overuse of this procedure.

Elective c-sections have been found to have higher rates of neonatal mortality compared with non-elective c-sections and vaginal births. Cesarean delivery is associated with higher risks to babies and mothers, including:

  • Breathing problems among babies.
  • Surgical injuries. 
  • An infection of the lining of the uterus. 
  • Postpartum hemorrhage. 
  • Delayed immune development and increased likelihood of developing allergies and asthma among babies. 

Cesarean delivery is much more costly than vaginal delivery (the average total charges to employer-provided commercial health insurance were $51,125 versus $32,093 in 2010). Out-of-pocket costs for cesarean deliveries continue to rise, averaging about $5,161 in 2015. Adverse outcomes and complications from overuse of cesarean delivery have substantial cost implications for health insurers, health care providers and the government, which pays for almost half of all births in the United States through Medicaid.

  • CDC WONDER, Natality Public Use Files, 2017

Prenatal Care Before Third Trimester, 2019 Health Of Women And Children Report
Measure: Prenatal Care Before Third Trimester, 2019 Health Of Women And Children Report

Why does this matter?

Adequate use of prenatal care is an important determinant of maternal and fetal health. Prenatal care is more likely to be effective if women begin receiving it during the first trimester of pregnancy, with continued visits until delivery. In 2017, 6 percent of reported births received late (third trimester only) or no prenatal care.

Regular prenatal care can reduce the risk of complications for both mothers and infants by: 

  • Encouraging a safe and healthy diet, including folic acid supplements
  • Promoting regular exercise
  • Warning pregnant women of the risk of potentially harmful substances such as alcohol and tobacco
  • Helping pregnant women manage existing health conditions such as high blood pressure, depression and diabetes
  • Identifying and treating infections, including sexually transmitted infections
  • Advising women to consider exclusive breastfeeding

Without prenatal care, an infant may be at higher risk of:

  • Sudden infant death syndrome
  • Neural tube defects
  • Fetal alcohol spectrum disorders
  • Adverse birth outcomes, including preterm birth, low birthweight, stillbirth, early neonatal death, late neonatal death and infant death
  • CDC WONDER, Natality Public Use Files, 2017

Well-Baby Check, 2019 Health Of Women And Children Report
Measure: Well-child Visit - Ages 0-2, 2019 Health Of Women And Children Report

Why does this matter?

The American Academy of Pediatrics recommends that infants receive frequent periodic preventive visits in their first year of life, known as well-baby visits.

Well-baby visits typically include:

  • Measurements of growth
  • Physical examination
  • Sensory screening
  • Developmental/behavioral assessment
  • Additional procedures (e.g. immunization and screenings) depending on age and risk

The benefits of well-baby visits include: 

  • Preventing illness through routine immunizations
  • Tracking growth and development
  • Having opportunities to discuss parental concerns about child development, behavior, sleep and eating
  • Developing a strong provider-patient relationship
  • Screening mothers for postpartum depression

Having regular checkups has been found to be associated with lower use of emergency care services. Well-baby visits are also associated with higher levels of school readiness.

  • National Survey of Children's Health, U.S. Department of Health and Human Services, Health Resources and Services Administration (HRSA), Maternal and Child Health Bureau (MCHB), 2016-2017

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