Cesarean sections, or C-sections, can be necessary in certain circumstances, but for most pregnancies — especially among women giving birth for the first time — a vaginal delivery is safer, with a lower risk of complications such as infection, blood loss, blood clots, and injury to organs.
An ACHI analysis of birth records and insurance claims data finds that for the period of 2019 through 2021, the statewide C-section rate among all mothers in Arkansas, including those with a previous C-section, was 33.5%, ranging from 26.2% in Johnson County to 45.6% in Dallas and Desha counties. In 2021, the national C-section rate among all mothers was 32.1%.
ACHI also examined C-section rates among first-birth mothers, defined as women giving birth for the first time with full-term pregnancies and singeltons — i.e., not twins or multiples — in a head-down position. For these mothers, the statewide C-section rate for the period of 2019 through 2021 was 27.6%, ranging from 15.2% in Woodruff County to 45.3% in Desha County. In 2021, the national C-section rate for first-time mothers was 26.3%.
Healthy People 2030, a federal initiative that identifies public health priorities, has set a national target of reducing the national C-section rate among first-birth mothers to 23.6%.
Our findings are presented in this infographic.
Other key takeaways include:
- Examining maternal county of residence, the five counties with the highest C-section rates for first-birth deliveries were Desha, 45.3%; Ashley, 42.5%; Chicot, 41.2%; Drew, 37.6%; and Stone, 35.7%. The five counties with the lowest rates were Woodruff, 15.2%; Searcy, 17.1%; Johnson, 17.8%; Marion, 18.4%; and Boone, 18.7%.
- The C-section rates for first-birth deliveries statewide were 32.5% for Black mothers and 36.6% for American Indian or Alaskan Native mothers, compared to 26.7% for White mothers.
- Examining maternal age, C-section rates for first-birth deliveries were 18.5% for mothers 20 or younger, 24.9% for mothers 21-24, 30% for mothers 25-29, 34.1% for mothers 30-34, 46.3% for mothers 35-39, and 54.5% for mothers 40 or older.
The infographic notes that Arkansas women of birthing age, i.e., 18-44, have high rates of diabetes, hypertension, and obesity, which could be a factor in C-section rates. The infographic also provides examples of policies that Texas, New Jersey, and Oklahoma have adopted to reduce unnecessary C-sections.
For more on this and related topics, see our Maternal and Infant Health page.
- March of Dimes. (2022, January). Total cesarean deliveries: United States, 2021. https://www.marchofdimes.org/peristats/data?reg=99&top=8&stop=86&lev=1&slev=1&obj=9&dv=ms
- Healthy People 2030. (2021). Reduce cesarean births among low-risk women with no prior births — MICH‑06. https://health.gov/healthypeople/objectives-and-data/browse-objectives/pregnancy-and-childbirth/reduce-cesarean-births-among-low-risk-women-no-prior-births-mich-06/data
- Keag, O.E., Norman J.E., & Stock, S.J. (2018). Long-term risks and benefits associated with cesarean delivery for mother, baby, and subsequent pregnancies: Systematic review and meta-analysis. PLOS Medicine, 15(1). https://doi.org/10.1371/journal.pmed.1002494
- America’s Health Rankings, United Health Foundation. (2023). Diabetes — women in Arkansas. https://www.americashealthrankings.org/explore/measures/diabetes_women/AR
- America’s Health Rankings, United Health Foundation. (2023). High blood pressure — women in Arkansas. https://www.americashealthrankings.org/explore/measures/hypertension_women/AR
- America’s Health Rankings, United Health Foundation. (2023). Obesity — women in Arkansas. https://www.americashealthrankings.org/explore/measures/Obesity_women/AR?population=Obesity_women_nonmetro
- (2019, April). Medicaid payment initiatives to improve maternal and birth outcomes. https://www.macpac.gov/wp-content/uploads/2019/04/Medicaid-Payment-Initiatives-to-Improve-Maternal-and-Birth-Outcomes.pdf
- New Jersey Hospital Association. (2023, January 4). NJHA patient safety initiative significantly reduces C-sections and maternal deaths. https://www.njha.com/pressroom/2023-press-releases/jan-4-2023-njha-patient-safety-initiative-significantly-reduces-c-sections-and-maternal-deaths/#:~:text=In%20addition%2C%20the%20C%2Dsection,figure%20of%2024.36%20in%202021.