Only 16% of U.S. counties offer labor after cesarean, study finds

Fewer than 16% of counties offered labor after cesarean section with many counties concentrated in the Northeast and Western states, a study found. Published in JAMA Network Open, the cross-sectional study used data from 2016 to 2021, which captured all U.S. births. The authors note insurance and transportation limitations could further limit labor after cesarean access for people in counties where hospitals offer it. Because vaginal birth after cesarean rates have risen in recent years, the authors hypothesize that labor after cesarean options may be concentrated among a smaller set of hospitals and clinicians. Future research should investigate the consequences of limited access on perinatal care experiences and outcomes for individuals with a prior cesarean delivery, they say. (JAMA Network Open research letter, 8/8/25)