Abstract
This paper estimates how changes in family structure and women’s labor market attachment during the last fifty years have affected the incidence of cesarean delivery in the United States. Both sets of factors are strongly related to cesarean utilization, and have generally changed so as to increase the rate of cesarean delivery over time. Altogether, changes in these factors, complemented by demographic changes, raised the U.S. cesarean section rate by 8-12 percentage points since 1978, one-half to two-thirds of the increase over that period. Today’s elevated cesarean section rate is, to a substantial degree, a social phenomenon.
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