Date of Award


Document Type


Degree Name

Doctor of Health Administration


College of Health Professions

First Advisor

Kit N. Simpson

Second Advisor

Annie N. Simpson

Third Advisor

Elizabeth A. Brown


Objective - To explore differences in cesarean delivery and induced labor between Generation X and Millennial women at the same age, 20-35 Method – A retrospective cohort study using the Nationwide Inpatient Sample (NIS) for the years 2001 and 2016. Women aged 20 to 35 in 2001(Generation X) and 2016 (Millennials) were included. OB outcome measures were compared at the same age to understand the trends in the interventions and the characteristics of women who receive them. Results - Millennial women compared to Generation-X women were 32% (95% CI 1.31-1.33) more likely to have cesarean delivery, and 28 % (95% CI 1.27-1.29) more likely to have induced labor. Furthermore, Millennial women were more likely to be older, have higher comorbidities, severe maternal morbidity (SMM), and longer length of hospital stay. Discussion –Millennial women have higher rates of cesarean delivery and induced labor even after controlling for age, race, and comorbidities. The results are an indication that obstetric interventions are routinely performed without medical indications.


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