ASPPH logo


Member Research & Reports

Member Research & Reports

BU Finds C-Section Rates Level Off After Sharp Increases

After years of sharp increases that were termed “inevitable,” births by cesarean section have plateaued in industrialized countries in recent years; however, rates in many countries remain high, according to a paper led by Boston University School of Public Health (BUSPH) researchers.

The study, in the American Journal of Obstetrics & Gynecology, examined C-section rates from 1993 to 2013 in 21 wealthy countries with at least 50,000 births. It found that the average increase in rates from 2008 to 2013 was only 1.5 percent—far less than the 40 percent average increase from 1993 to 2003. Of the 21 countries, six reported declines from 2008 to 2013, and none experienced a significant increase.

The report, led by Dr. Eugene Declercq, professor of community health sciences at BUSPH, shows seven countries had cesarean rates over 30 percent in 2013: Australia, Germany, Italy, Portugal, the Slovak Republic, Switzerland, and the US. Of those countries, Italy and Portugal saw a decline from 2008, while the others reported small or no increase in cesareans.

“Cesarean rates in industrialized countries have generally plateaued, but at rates that are higher than recommended by WHO (the World Health Organization),” the study says.

To read more about the study, go to: