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The U.S. C-section rate hit another all-time high in 2004, according to preliminary government data released Tuesday.
In 2004, 29.1% of all births were C-sections, a 40% increase since 1996, the Centers for Disease Control and Prevention's National Center for Health Statistics reported.
"I keep wondering what that breaking point is going to be," says San Marcos, Calif., resident Tonya Jamois, president of the International Cesarean Awareness Network, an advocacy group that promotes vaginal delivery. "I'm concerned that people are going to see this almost 30% number and say, 'OK, it's no big deal.'"
One reason for the rising C-section rate is the declining percentage of women who deliver vaginally after a prior C-section.
Liability concerns have driven a rising number of hospitals to ban vaginal births after cesareans, or VBACs, because of a slight risk of uterine tears.
In 2004, only 9.2% of women with a prior C-section delivered vaginally, down 13% from 2003. Since 1996, the VBAC rate has fallen 67%, from a peak of 28.3%.
Yet, in the most definitive study to date, published last December, three-fourths of women who attempted a VBAC were successful. Fewer than 1% of them had a uterine tear, and in the vast majority of cases, mother and baby did fine.
Among other preliminary births data for 2004:
*More than a half-million babies were born prematurely (before 37 weeks), the highest number reported since the government began collecting data in 1981. One of every eight live-born infants was premature. Since 1990, the premature birth rate has climbed 18%, hitting 12.5% in 2004.
*The rate of babies with a low birth weight (5 1/2 pounds or less) rose from 7.9% in 2003 to 8.1% in 2004. Since 1990, the low-birth-weight rate has risen 16%.
*As in 2003, about 84% of women began getting prenatal care in the first trimester.
And the percentage of women who did not get care until their last trimester, if at all, rose slightly, from 3.56% in 2003 to 3.59% in 2004.
*The percentage of pregnant women who smoked fell from 10.4% in 2003 to 10.2% in 2004. Tobacco use during pregnancy has been falling at least since 1989.
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