MOTHERS IN SOME PARTS OF ARKANSAS MUCH MORE LIKELY TO DELIVER VIA C-SECTION, ACHI ANALYSIS SHOWS

LITTLE ROCK — Mothers who live in certain parts of Arkansas are much more likely to give birth through cesarean section, or C-section, than mothers in other parts of the state, an analysis of birth records by mothers’ county of residence and insurance claims data by the Arkansas Center for Health Improvement shows.

ACHI found 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, for purposes of the analysis 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%.

A C-section is used to deliver a baby through surgical incisions made through the abdomen and uterus. 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-time mothers to 23.6%. The procedure 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.

Other findings 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 wide variation in C-section rates by county of residence shows that where you live has a lot to do with your likelihood of delivering by C-section,” said ACHI President and CEO Dr. Joe Thompson. “These variations are likely associated with both disparate health risks among the mothers and the journey they experience through their pregnancy. Health care providers, stakeholders and policymakers should explore the reasons behind these differences and work to ensure that mothers only receive this procedure when it is necessary, wherever they live.”

ACHI published an infographic on its findings, available at achi.net/library/c-section. 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.

The analysis is another contribution to ACHI’s “Birthing Journey” project, which seeks to raise awareness, promote discussion and inform health care providers, stakeholders and policymakers as they address Arkansas’ maternal mortality rate, the highest in the nation. More information on the project, including ACHI’s infographic illustrating “9 Points on a Healthy Birthing Journey,” is available at achi.net/maternal-infant-health.

ACHI is a nonpartisan, independent health policy center that serves as a catalyst for improving the health of all Arkansans through evidence-based research, public issue advocacy, and collaborative program development.