Changes in indications for Cesarean delivery: United States, 1985 and 1994

Objectives. The percentages of cesarean deliveries attributable to specific indications (breech, dystocia, fetal distress, and elective repeat cesarean) were computed for 1985 and 1994. Methods. Data were derived from the 1985 and 1994 National Hospital Discharge Surveys. Results. Dystocia was the leading indication for cesarean delivery in both years. In comparison with 1985, cesareans performed in 1994 that were attributable to dystocia and breech presentation increased, those attributable to fetal distress did not change significantly, and elective repeat cesareans declined. Conclusions. Studying indications for cesareans can be useful for hospitals, clinicians, and researchers in determining strategies to lower primary and repeat cesarean rates. (Am J Public Health. 1998;88:1384-1387)