The number of Cesarean births in the United States is now the highest on record.
The National Center for Health Statistics says more than a quarter of babies born in 2003 were delivered surgically. That's up a third since 1996.
The report does not distinguish between Cesareans that are medically necessary and those that are elective, which has sparked controversy.
The National Center for Health Statistics also notes that birth rates for teen-agers continued their steady decline, while increasing for women ages 35 to 44.
The report did find one unexplained trend. There continues to be an increase in the rate of premature and low-birthweight babies despite more prenatal care, fewer teen births and fewer women smoking while pregnant.
Nearly four-point-one (m) million babies were born in the United States last year, a slight increase over 2002.