From Our Data Team: NTSV C-Section Trends
Nulliparous, term, singleton, vertex (NTSV) deliveries constitute a low-risk group of women that is used in the evaluation of cesarean delivery practices and the quality of medical services provided. Efforts aimed at minimizing the number of primary cesarean deliveries should be prioritized because cesarean birth has been associated with increased maternal and neonatal risks, as well as complications in future pregnancies.
The following study was a retrospective observational study that examined NTSV cesarean trends, predictors and disparities within Southern New Jersey births from 2020 to 2024. From 2020 to 2024, 29,247 births were NTSV, out of which 7,034 deliveries were completed by cesarean, yielding an overall NTSV cesarean rate of 24%. While Southern New Jersey performed better than New Jersey state average and national average, the region did not achieve the Healthy People 2030 target of 23.6%.
It was observed that NTSV cesareans were more likely in deliveries that were induced, obese patients, in non-Hispanic Blacks in comparison to non-Hispanic Whites, and in pregnancies affected by gestational diabetes or gestational hypertension. Geographic differences were observed, too. In some counties, there were fewer cesareans despite more inductions, while in others, the rate was higher for patients who had been induced. Overall, the study showed that while southern New Jersey’s NTSV cesarean rates are relatively lower than broader benchmarks, rates remain higher than the Healthy 2030 target. The results support continued quality improvement efforts focused on labor management, risk reduction, and closer examination of county and facility-level practice patterns to better reduce unnecessary cesarean delivery and improve maternal outcomes.
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