Accounting for the Rise in C-Sections: Evidence from Population Level Data

Abstract

Drawing on administrative records of nearly 4 million births in Canada as well as macro data from the US and Australia, we provide a comprehensive account of rising C-section rates. We explicitly consider the contributions of the changing characteristics of mothers, births, and physicians as well as changing financial incentives for C-section deliveries. These factors account for at most one-half of the increase in C-section rates. The majority of the remaining increase in C-sections over the period 1994-2011 occurred in the early 2000s. We overview the relative contributions that the Hannah Breech Trial and technological change may have played in this development.