First Births: A Review of the United States Primary Cesarean Section Rate And Recommendations for Further Study

The cesarean section (CS) rate has increased exponentially worldwide over the past twenty years, and today it is the “most common major surgical procedure in the United States” (Boyle et al., 2013). CS is associated with increased morbidity and mortality for both mothers and newborns, and lowering the national CS rate has become a national health concern (American College of Obstetricians and Gynecologists, 2014). Once a woman has her first CS (the primary CS), it is very likely that all of her subsequent deliveries will also be by CS. Thus, preventing primary CS is critical for reducing the overall CS rate (ACOG, 2014). This paper explores factors contributing to the elevated CS rate, and specifically examines the diagnosis of labor dystocia. The nurse’s role in promoting normal birth and preventing CS is also outlined. Lastly, emerging programs intended to address the elevated CS rate are discussed