The most common reasons a first cesarean is done
Four reasons account for most of them.
In a large US study of first cesareans, the reasons broke down roughly as follows: labor that stopped progressing about 35%, a concerning fetal heart rate pattern roughly one quarter (reported between 24% and 27% within the same dataset), the baby not being head down about 19%, and everything else (preeclampsia, twins, suspected big baby, prior surgery, fetal problems) making up the rest.
Notice that the two largest categories, arrest of labor and a worrying monitor tracing, are both judgment calls. Neither has a single objective test behind it. That is precisely why rates vary so much between hospitals.
Where this comes from:
277. Boyle A, Reddy UM, Landy HJ, Huang CC, Driggers RW, Laughon SK. Primary cesarean delivery in the United States. Obstet Gynecol. 2013;122(1):33-40.
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