Cover: Variations in the Use of Cesarean Sections

Variations in the Use of Cesarean Sections

Literature Synthesis

Published 1995

by Joanna Heilbrunn, Rolla Edward Park


Download eBook for Free

FormatFile SizeNotes
PDF file 2.4 MB

Use Adobe Acrobat Reader version 10 or higher for the best experience.


Purchase Print Copy

 Format Price
Add to Cart Paperback80 pages $25.00

This research is part of the Management and Outcomes of Childbirth Patient Outcomes Research Team (PORT), which is supported by the Agency for Health Care Policy and Research. This report summarizes the literature on variations in the use of cesarean section for childbirth, including variations over time, geographic variations, and clinical and nonclinical correlates of variations. The literature describes dramatic increases in aggregate C-section rates over time, and dramatic differences among countries, regions, states, and smaller areas. The changes over time can be largely attributed to changes in the four major diagnoses that lead to most C-sections: more frequent diagnoses of prior C-section, dystocia, fetal distress, and higher C-section rates for breech diagnoses. But these attributions still fail to explain why C-section rates have increased so dramatically in the last two decades.

This report is part of the RAND monograph report series. The monograph/report was a product of RAND from 1993 to 2003. RAND monograph/reports presented major research findings that addressed the challenges facing the public and private sectors. They included executive summaries, technical documentation, and synthesis pieces.

This document and trademark(s) contained herein are protected by law. This representation of RAND intellectual property is provided for noncommercial use only. Unauthorized posting of this publication online is prohibited; linking directly to this product page is encouraged. Permission is required from RAND to reproduce, or reuse in another form, any of its research documents for commercial purposes. For information on reprint and reuse permissions, please visit

RAND is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.