So in this topic we're going to talk about routine care versus evidence-based care.

And by the end of this video, you'll be able to describe the current caesarian rates,

induction rates, and V-back rates in the U.S., list non-evidence-based procedures that are overused,

list helpful treatments that are underused, and discuss some of the racial disparities that we see

in the United States.

So this graph shows the total caesarian rate in yellow here, the primary cesarean rate

in orange, and the VBAC rate or vaginal birth after cesarean rate in blue.

As you can see, the cesarean rate in the United As you can see, the cesarian rate in the United States

rose drastically from about 5% in the early 1970s

to a high of 33%, and now it currently hovers

at around 32%.

So currently one out of three pregnant people

in the United States gives birth surgically by cesarean.

Also, 26% of low risk first time mothers give birth by cesarean.

The two main factors or drivers behind the high cesarean rates in the United States and in other countries where they have high cesarean rates are the high primary

cesarian rates and the low rates of vaginal birth

after caesarian or V-back. A primary cesarian is when someone who does not have a cesarian scar

has a cesarian. This could be a first-time mother, or it could be someone who's given birth

vaginally before. Research has shown that almost half of the increase in cesarean rates at

hospitals can be attributed to an increase in primary cesarean rates. So it's critical that we

understand the factors that lead to primary caesarians because by doing so, we could possibly

reduce the total caesarian rate. In discussing V-back, in 2010, the National Institutes of Health

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