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Geographic Variation in Cesarean Sections in the United States: Trends, Correlates, and Other Interesting Facts

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  • Sarah Robinson
  • Heather Royer
  • David Silver

Abstract

Analyzing data spanning three decades covering the near universe of births, we study county-level differences in Cesarean section (C-section) rates among first-time mothers of singleton births. Our research reveals persistent geographic variation in C- section rates for both low- and high-risk groups. Counties with elevated C-section rates consistently perform more C-sections across mothers at all levels of appropriateness for the procedure. These elevated rates of C-section in high C-section counties are associated with reduced maternal and infant morbidity. We also find that C-section decisions are less responsive to underlying risks for Black mothers relative to white mothers, suggesting potential welfare-reducing disparities.

Suggested Citation

  • Sarah Robinson & Heather Royer & David Silver, 2023. "Geographic Variation in Cesarean Sections in the United States: Trends, Correlates, and Other Interesting Facts," NBER Working Papers 31871, National Bureau of Economic Research, Inc.
    • Handle: RePEc:nbr:nberwo:31871
    Note: CH EH
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    JEL classification:

    • I1 - Health, Education, and Welfare - - Health

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