Cesarean sections are one of the most common surgical procedures in the world. In the United States, about 32.4% of all births in 2024 were delivered by C-section, meaning roughly one in three babies arrives this way. Globally, the rate sits around 21%, up from just 7% in 1990. Both numbers exceed the World Health Organization’s recommended range of 10 to 15%, above which higher rates don’t improve outcomes for mothers or babies.
C-Section Rates in the United States
The U.S. cesarean rate has climbed dramatically over the past half-century. In the 1960s, fewer than 5% of births were surgical. That figure rose sevenfold over the following decades, peaking at 32.9% in 2009. After a brief plateau, the rate held steady in the low 32% range and ticked up slightly to 32.4% in 2024, according to provisional CDC data.
Rates vary significantly by state. Mississippi had the highest cesarean rate in 2023 at 37.9%, followed by Florida (36.2%) and Louisiana (36.1%). Alaska had the lowest at 24%, with Utah (24.3%) and South Dakota (24.4%) close behind. Southern states consistently cluster at the higher end, a pattern that reflects differences in hospital practices, patient demographics, and access to midwifery care.
Why C-Sections Are Performed
The single most common reason for a first-time cesarean is labor that stalls, sometimes called failure to progress. This accounts for about 35% of all primary C-sections. The baby’s head may not descend through the pelvis despite strong contractions, or the cervix may stop dilating. The second most common reason, at roughly 24%, is a concerning fetal heart rate pattern during labor, which can signal the baby isn’t tolerating contractions well. Fetal malpresentation, most often a breech position, makes up about 19% of first-time cesareans.
Less frequent but still notable reasons include preeclampsia (about 3.4% of primary C-sections) and carrying twins or other multiples (3.1%). In some cases, no medical indication exists at all. An estimated 2.5% of all U.S. births are cesarean deliveries performed at the mother’s request, which represents roughly 18% of cesarean deliveries worldwide.
How Age Affects Your Likelihood
Maternal age is one of the strongest predictors of cesarean delivery. Among first-time mothers in 2024, those aged 35 to 39 had a primary cesarean rate of 26.9%, while mothers 40 and older had a rate of 34.5%. For comparison, younger first-time mothers have rates in the low 20s. The reasons behind this trend include higher rates of pregnancy complications like preeclampsia and gestational diabetes at older ages, along with a greater likelihood of labor interventions.
Repeat C-Sections Drive the Numbers
A major reason the overall cesarean rate stays above 30% is that most women who have one C-section go on to have another. Only about 8.5% of women with a prior cesarean deliver vaginally in subsequent pregnancies. That’s a steep drop from the mid-1990s, when nearly 28% achieved a vaginal birth after cesarean (VBAC). The decline happened after reports of rare but serious uterine rupture during labor, which made many hospitals and providers more cautious.
When women do attempt labor after a previous cesarean, the success rate is encouraging: about 74% deliver vaginally. The challenge is that fewer women are offered or encouraged to try. Many hospitals, particularly smaller or rural ones, don’t support VBAC attempts because they lack the surgical staff needed to respond quickly if complications arise.
Measuring “Low-Risk” Cesareans
Health officials track a specific subset of C-sections to gauge whether hospitals are performing too many: cesareans among first-time mothers carrying a single baby in a head-down position at full term. This group, called NTSV births, represents the lowest-risk scenario for vaginal delivery. If a hospital’s cesarean rate is high in this group, it suggests surgical deliveries are happening when they may not be necessary.
The national NTSV cesarean rate was 26.6% in 2024. The federal Healthy People 2030 target is 23.6%, a benchmark the country has not yet reached. This metric matters because it strips away the cases where a C-section is clearly needed (breech babies, twins, repeat cesareans) and focuses on the births where labor management and clinical decision-making have the most influence.
How Global Rates Compare
The worldwide picture is one of extremes. Developed countries average a cesarean rate around 27%, while some developing countries sit below 5%, often because women lack access to surgical care even when they need it. Latin America and the Caribbean have some of the highest regional rates, with countries like Brazil and the Dominican Republic exceeding 50%. Sub-Saharan Africa, by contrast, has rates well under 10% in many countries, contributing to preventable maternal and newborn deaths.
The WHO’s position is that cesarean rates between 10 and 15% optimize outcomes. Below 10%, some women who need surgical delivery aren’t getting it. Above 15%, the additional surgeries don’t reduce maternal or infant mortality and instead introduce unnecessary surgical risks.
Risks Compared to Vaginal Delivery
Cesarean delivery is major abdominal surgery, and it carries a different risk profile than vaginal birth. Overall maternal complications occur in about 11% of cesarean deliveries compared to 8% of vaginal births. The most significant difference is infection: postpartum infection is the most common complication of C-sections, and antibiotic use after cesarean delivery runs about three times higher than after vaginal birth. Recovery also takes longer, typically four to six weeks for a cesarean versus one to two weeks for an uncomplicated vaginal delivery.
The risks compound with each subsequent cesarean. Scar tissue builds up, and the placenta in future pregnancies is more likely to attach abnormally, a condition that can cause life-threatening bleeding. This is one reason public health efforts focus on reducing unnecessary first-time cesareans, since that first surgery often sets the course for every delivery that follows.