Reduce cesarean births among low-risk women with no prior births — MICH‑06 Data Methodology and Measurement

About the National Data

Data

Baseline: 25.9 percent of low-risk females with no prior birth had a cesarean birth in 2018

Target: 23.6 percent

Numerator
Number of first births delivered by cesarean section to low-risk females (full-term, singleton, vertex presentation).
Denominator
Number of first births to low-risk females (full-term, singleton, vertex presentation).
Target-setting method

Projection

Target-setting method details
Linear trend fitted using weighted least squares and a projection at the 75 percent prediction interval.
1
Target-setting method justification
Trend data were evaluated for this objective. Using historical data points, a trend line was fitted using weighted least squares, and the trend was projected into the next decade. This method was used because three or more comparable data points were available, the projected value was within the range of possible values, and a projection at the 75 percent prediction interval was selected because, while the overall trend from 2008 to 2017 was decreasing, 2014 to 2017 showed no change.

Methodology

Methodology notes

A low-risk female is defined as nulliparous (never given birth before), full-term (at least 37 weeks of gestation, based on obstetric estimate of gestation at delivery), singleton (not a multiple) pregnancy, with a vertex fetus (head facing in a downward position in the birth canal).

Data for the obstetric estimate measure are based on the 2003 U.S. Standard Certificate of Live Birth item "Obstetric estimate of gestation." The obstetric estimate of gestation is defined as "the best obstetric estimate of the infant's gestation in completed weeks based on the birth attendant's final estimate of gestation".

History

Comparable HP2020 objective
Retained, which includes core objectives that are continuing from Healthy People 2020 with no change in measurement.

References

Additional resources about the objective

Martin JA, Osterman MJK, Kirmeyer SE, Gregory ECW. Measuring gestational age in vital statistics data: Transitioning to the obstetric estimate. National vital statistics reports; vol 64 no 5. Hyattsville, MD: National Center for Health Statistics. 2015.

1. Because Healthy People 2030 objectives have a desired direction (e.g., increase or decrease), the confidence level of a one-sided prediction interval can be used as an indication of how likely a target will be to achieve based on the historical data and fitted trend.