C-Section Rates in Arkansas, 2021-2023

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. Arkansas women ages 18-44 have higher rates of diabetes, hypertension, and obesity than women nationally, which could be a factor in C-section rates.

As an update to our previous analysis for the period of 2019-2021, ACHI examined C-section rates among first-birth mothers in 2021-2023. First-birth mothers are defined as women giving birth for the first time with full-term pregnancies and singletons — i.e., not twins or multiples — in a head-down position. For these mothers, the statewide C-section rate was 27.5%, ranging from 11.7% in Fulton County to 39.2% in Drew County. In 2023, the national C-section rate for first-time mothers was 26.6%.

Healthy People 2030, a federal initiative that identifies public health priorities, has established a target to reduce the national rate of first-birth C-section deliveries to 23.6%.

ACHI also examined the overall C-section rate both statewide and by county for the period of 2021-2023. The statewide C-section rate among all mothers in Arkansas, including those with a previous C-section, was 33.2%, ranging from 23.7% in Searcy County to 45% in Calhoun County. In 2023, the national C-section rate among all mothers was 32.3%.

Our findings for the period of 2021-2023 are presented in this infographic, which also highlights the counties with the largest increases and decreases in C-section rates — for both first-birth and overall C-section deliveries — compared with our previous analysis.

Other key takeaways include:

• Among first-birth deliveries, Lee, Sevier, Cleveland, Hot Spring, and Howard counties had the largest percentage point increases in first-birth C-section rates for 2021-2023, compared with the period of 2019-2021. Lawrence, Desha, Clay, Fulton, and Stone counties had the largest percentage point decreases for 2021-2023, compared with the period of 2019-2021.
• Among overall C-section rates, Calhoun, Logan, Lee, Sevier, and Mississippi counties had the largest percentage point increases in overall C-section rates for 2021-2023, compared with the period of 2019-2021. Lafayette, Clay, Izard, Dallas, and Lawrence counties had the largest percentage point decreases for 2021-2023, compared with the period of 2019-2021.

From 2023 to 2025, 94% of Arkansas’s birthing hospitals participated in the Arkansas Perinatal Quality Collaborative’s Safe Reduction of Primary Cesarean Birth initiative, implementing the Alliance for Innovation on Maternal Health patient safety bundle to decrease first-birth C-section deliveries. The high participation rate among birthing hospitals in the state demonstrates a commitment to reducing unnecessary C-section rates. This effort largely occurred after the period examined here, and ACHI will continue to track first-birth C-section rates in future analyses.