Cesarean Birth in BC

The rate of cesarean birth in Canada has risen dramatically over the past few decades, a trend consistent across other developed countries. The Canadian cesarean rate has risen steadily since the mid 1990s, from 18.7% in 1997 to 26.7% in 2007 and now to 28.2% in 2016.

The graph below illustrates the trend of increasing cesarean births in British Columbia from 1999-2016.

CS BC 1999-2016Click on graph to enlarge

The cesarean rate in British Columbia is the highest in Canada, at 35.3% in 2016-2017. There is wide variability in cesarean rates across the provinces and territories, ranging from 18.5% in the Northwest Territories to 30.3% in Newfoundland and Labrador. This suggests that there is room to safely decrease cesarean rates while simultaneously improving maternal and infant outcomes and reducing use of scarce health resources.

CS Canada by Prov Terr 2016Click on graph to enlarge

Cesarean birth is associated with higher rates of maternal and newborn morbidity and death compared to vaginal birth, and uses considerable health care resources. The average cost of cesarean birth in BC ranges from $3,308 to $5,511, whereas vaginal birth costs on average $1,898 to $3,328.3

In BC and Canada, our maternal demographic is changing. More women over the age of 35 are giving birth and maternal obesity, excessive weight gain during pregnancy and increasing rates of multiple pregnancies contribute to the trend of increasing cesarean births.

The graphs below illustrate the rates of primary cesarean birth in all BC health regions for the years 2011 and 2016. These graphs show that the primary cesarean rate increased among women both under and over 35 years of age. Our increasing cesarean birth rate cannot be entirely attributed to changing maternal demographics.

Primary CS BC over equal 35 yearsClick on graph to enlarge

Primary CS BC less than 35 yearsClick on graph to enlarge

References
1. Canadian Institute for Health Information. Health Indicators Interactive Toolhttps://yourhealthsystem.cihi.ca/epub/search.jspa
2. Canadian Institute for Health Information. Discharge Abstract Database/Hospital Morbidity Database. https://apps.cihi.ca/mstrapp/asp/Main.aspx?
3. Canadian Institute for Health Information. Patient Cost Estimator. 2014-2015. https://www.cihi.ca/en/patient-cost-estimator