What ordinary labor now involves
Most women in the United States have an epidural. About a third have a cesarean. Neither is a failure.
Before you decide what you want, it helps to know what is usual. All of these are per live birth, 2024, from the national birth file.
| What happened | Share of 2024 live births | Number |
|---|---|---|
| Epidural or spinal anesthesia in labor | 78.1% | 2,833,607 |
| Induction of labor | 33.9% | 1,229,728 |
| Cesarean delivery, all | 32.4% | |
| Antibiotics given to the mother in labor | 24.6% | 893,135 |
| Augmentation of labor | 21.0% | 761,000 |
| Forceps or vacuum | 2.7% | 96,921 |
| Antenatal steroids for the baby's lungs | 3.6% | 131,053 |
| Attempt to turn a breech baby | 0.35% | 12,779 |
Three further figures you will be quoted are not out of all births. Two of them are cesarean rates and one, the VBAC rate, is a vaginal birth rate. Each has its own bottom, and none of them belongs in the table above.
| Measure, 2024 | Rate | Out of what |
|---|---|---|
| Low-risk first births | 26.6% | Nulliparous, term, singleton, head-first births |
| First cesarean for that woman | 22.9% | Births to women without a previous cesarean |
| Vaginal birth after a previous cesarean | 15.5% | Births to women with a previous cesarean |
NCHS spells each of those out in its own definitions. Low-risk means cesarean delivery among nulliparous (first birth), term (37 completed weeks or more based on the obstetric estimate), singleton (one fetus), and cephalic (head first) births.
The primary rate is number of births to women having a cesarean delivery per 100 births to women without a previous cesarean.
The vaginal-birth-after-cesarean rate is number of births to women having a vaginal delivery per 100 births to women with a previous cesarean delivery.
What has changed since 2016. Epidural or spinal anesthesia rose from 73.6% to 78.1% of live births. Total cesarean rose slightly, from 31.9% to 32.4%. Low-risk cesarean rose from 25.7% to 26.6%. NCHS notes that the cesarean rate peaked in 2009 at 32.9%, after increasing every year since 1996 (20.7%).
What has fallen. Forceps births went from 21,674 a year to 14,946. Vacuum births went from 100,602 to 81,975. In a country with 8% fewer births than in 2016, forceps use fell by about a third.
"What is this hospital's own cesarean rate for women having a first baby, single, head down, at term?"
"If I end up wanting an epidural after saying I did not, will anyone make me feel bad about it?"