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The U.S. has one of the highest cesarean delivery rates in the world, and safely lowering this rate is an explicit objective of the Department of Health and Human Services. In a retrospective study of data from the Consortium on Safe Labor involving >38,000 primary cesarean deliveries (PCDs), researchers sought to delineate the factors that underlie this rate.
The PCD rate was 31% for primiparous women and 12% for multiparous women. The most common indications for PCD were failure to progress (35%), nonreassuring fetal heart rate tracings (27%), and fetal malpresentation (18%). Among women with failure to progress, 41% never attained cervical dilation beyond 5 cm. Of women who did reach second-stage labor, 17% underwent PCD for arrest of des…