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Pregnancy & Birth

Comparing the Risks of Cesarean Births Versus Vaginal Births

The information below is adapted from the Childbirth Connection booklet “What Every Pregnant Woman Needs to Know About Cesarean Section.” The booklet provides an extensive review of the best available research on cesarean sections and is available for free download. 

While most mothers and babies who have cesarean births do fine, cesarean sections involve more risks than “spontaneous” vaginal births (births that do not involve the use of forceps, vacuum extraction, or a cesarean). Women who have cesarean sections have more infections after the birth (usually in the uterus, bladder, or incision, and including infections resistant to antibiotics), more pain, longer recovery periods, and a greater chance of being rehospitalized. Women who have cesareans are also at a slightly increased risk of rare complications such as blood clots and bowel obstructions.

A woman who has had a cesarean section is more likely to have a cesarean section in future pregnancies. As the number of C-sections increases for a woman, the risk of complications in future pregnancies also increases. Potential complications include ectopic pregnancy (pregnancy that develops outside the uterus), placenta previa (when the placenta attaches near or over the opening of the cervix) and other placental problems, and, during birth, rupture of the uterus. With each cesarean section, it is common to encounter more scar tissue in the area of the previous incision. This can lead to greater blood loss and a longer operating time for the next cesarean. A rare complication of repeat cesarean sections that is being seen more often because more cesareans are being performed in the United States is an abnormal attachment of the placenta, in which the placenta grows deeply into or through the wall of the uterus in the area of the previous scar. The placenta may even grow into the wall of the bladder. It then becomes difficult to remove, resulting in blood loss that is difficult to control and possible injury to the bladder. In cases such as this, a hysterectomy may be needed at birth to prevent severe hemorrhage.

In addition, babies born via cesarean section are more likely to have mild respiratory problems in the newborn period than babies born vaginally, and they are more likely to experience asthma in childhood and adulthood. Babies born via cesarean section are less likely to establish breast-feeding, although plenty of such babies do breast-feed.2

Unless there is a clear, compelling medical reason for you to have a cesarean section, having a vaginal birth is likely to be the safest option for both you and your baby.

For more information, see What Every Pregnant Woman Needs To Know About Cesarean Section.

Notes

2. Childbirth Connection, “Cesarean Section: Best Evidence: C-Section,” accessed at www.childbirthconnection.org/article.asp?ck=10166 on July 25, 2006.  [return to text]

Excerpted from Chapter 13: Cesarean Births in Our Bodies, Ourselves: Pregnancy and Birth  © 2008 Boston Women's Health Book Collective.

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