The Risks of Cesarean Delivery to Mother and Baby

A CIMS Fact Sheet

The Coalition for Improving Maternity Services (CIMS) is concerned about the dramatic increase
and ongoing overuse of cesarean section. Every year since 1983 no fewer than one in five American women
has given birth via major abdominal surgery. 22,34 Today one in four or 25% of women have a cesarean for the
birth of their baby. 22 The rate for first-time mothers may approach one in three. 9 Studies show that the
cesarean rate could safely be halved. 11 The World Health Organization recommends no more than a 15%
cesarean rate. 34 With a million women having cesarean sections every year, this means that 400,000 to 500,000
of them were unnecessary.

No evidence supports the idea that cesareans are as safe as vaginal birth for mother or baby. In fact,
the increase in cesarean births risks the health and well being of childbearing women and their babies.
For elective repeat cesarean, the consensus of dozens of studies totaling tens of thousands of women
is that elective repeat cesarean section is riskier for the mother and not any safer for the baby. 24,27,28 Recent
studies used to conclude otherwise are both seriously flawed and have been misrepresented in the media. 12
In addition to the hazards of cesarean section per se, the risks of certain complications increase with
accumulating surgeries. Studies also show that with a history of previous cesarean, seven out of ten women or
more who are allowed to labor without undue restrictions will give birth vaginally, thus ending their exposure to
the dangers of cesarean section.13

Hazards of Cesarean Section to the Mother

· Women run 5 to 7 times the risk of death with cesarean section compared with vaginal birth. 14,29
· Complications during and after the surgery include surgical injury to the bladder, uterus and blood
vessels (2 per 100), 30 hemorrhage (1 to 6 women per 100 require a blood transfusion), 30 anesthesia
accidents, blood clots in the legs (6 to 20 per 1000), 30 pulmonary embolism (1 to 2 per 1000), 30
paralyzed bowel (10 to 20 per 100 mild cases, 1 in 100 severe), 30 and infection (up to 50 times more
common). 1
· One in ten women report difficulties with normal activities two months after the birth, 23 and one in
four report pain at the incision site as a major problem. 9 One in fourteen still report incisional pain six
months or more after delivery. 9
· Twice as many women require rehospitalization as women having normal vaginal birth. 18
· Especially with unplanned cesarean section, women are more likely to experience negative emotions,
including lower self-esteem, a sense of failure, loss of control, and disappointment. They may develop
postpartum depression or post-traumatic stress syndrome. 9,20,25,31 Some mothers express dominant
feelings of fear and anxiety about their cesarean as long as five years later. 16
· Women having cesarean sections are less likely to decide to become pregnant again. 16
· As is true of all abdominal surgery, internal scar tissue can cause pelvic pain, pain during sexual
intercourse, and bowel problems.
· Reproductive consequences compared with vaginal birth include increased infertility, 16 miscarriage, 15
placenta previa (placenta overlays the cervix), 19 placental abruption (the placenta detaches partially or
completely before the birth), 19 and premature birth. 8 Even in women planning repeat cesarean, uterine
rupture occurs at a rate of 1 in 500 versus 1 in 10,000 in women with no uterine scar. 27

The Risks of Cesarean Delivery
to Mother and Baby
www.motherfriendly.org
A CIMS Fact Sheet