Research Brief: Trends in Cesarean Birth in the United States 1965 to 2025.

Cesarean birth is a contributing factor to maternal morbidity and mortality (American College of Obstetricians and Gynecologists, 2025; Chaillet et al., 2026; Jauniaux et al., 2026). The cesarean birth rate in the United States is one of the highest among peer countries (National Academies of Sciences, Engineering, and Medicine, 2020). Like other aspects of maternity care, there are disparities in exposure to cesarean birth when rates are analyzed based on maternal race and ethnic group. Non-Hispanic Black women continue to have higher rates of cesarean birth compared to non-Hispanic White women (Boller et al., 2025). Purpose The purpose of this study was to identify cesarean birth rates and trends over the last 60 years in the United States. The time frame was selected because of reliable national data. Data on cesarean births in the United States were collected starting in 1965 from the National Hospital Discharge Survey, a national probability sample of select short stay (average <30 days) US non-federal hospitals (National Center for Health Statistics [NCHS], 2015). In 1965, approximately 300 short-stay hospitals participated in the survey of a national sample of ∼7,000. In the years 1965 to 1991, samples ranged from approximately 300 to 500 (Graves, 1993). In 1989, method of birth started to be collected from the U.S. Standard Certificate of Live Birth and was first published in 1993 (NCHS, 1992; U.S. Department of Health and Human Services Public Health Service et al., 1993). Since then, most researchers cited birth certificate data for reporting cesarean birth rates (Menacker et al., 2006). Selected birth certificate data from 1995 and on are available on the Centers for Disease Control and Prevention (CDC) Wide-ranging ONline Data for Epidemiologic Research (WONDER) site (CDC & NCHS, 2026a). There are five categories of natality data sets, each with differences based on data that were collected and compiled from birth certificates during those periods: final natality data 1995 to 2002, 2003 to 2006, 2007 to 2024, and 2016 to 2024 (expanded), and provisional data 2023 to last month (CDC & NCHS, 2026a). Starting in 2003, method of birth is available in these data sets. The most complete data are from the last two categories: expanded and provisional covering 2016 up to last month. Complete data from US birth certificates from the last 10 years are available for analysis. Methods Various sources were used to identify and then verify cesarean birth rates from 1965 to 2025. Researchers from the National Center for Health Statistics used National Hospital Discharge Survey data to publish a series of reports on cesarean rates in the United States from 1965 to 1990 (CDC, 1995; Placek & Taffel, 1980; Placek et al., 1983; Taffel et al., 1992; Taffel et al., 1987). Cesarean rates from 1965 to 1990 were verified by at least two sources. Cesarean rates from 1991 to 2025 were identified in National Vital Statistics Reports (Menacker & Curtin, 2001), NCHS Data Briefs (Menacker & Hamilton, 2010; Osterman & Martin, 2013), and Births, Final Data for each year (CDC Wonder, 2026). Cesarean birth rates from 2003 to 2025 were verified via CDC Wonder Natality Data final birth certificate files (CDC & NCHS, 2026a,2026b). Final data files were considered most accurate. Provisional data for 2025 were posted January 28, 2026 (CDC & NCHS, 2026b). Results The cesarean birth rate in the United States has risen significantly over the last 60 years, from 4.5% of births in 1965 (NCHS, 1965-1987; Taffel et al., 1987) to 32.4% of births in 2025, an over 600% increase (CDC & NCHS, 2026b). Data are presented in the Figure in 5-year increments. There was a steep (∼400%) increase in the cesarean rate from 1965 (4.5) to 1985 (22.7). From 1985 to 2000, the rate stabilized (22.7-22.9). From 2000 to 2010, the rate increased 43% from 22.9 to 32.8 followed by minimal change since then (CDC & NCHS, 2026a,2026b). Approximately one-third of births in the United States are via cesarean and have been for the last 20 years.Figure: Cesarean Birth Rate United States 1965 to 2025.