Researchers with the World Health Organization published a huge study this week in the British Medical Journal finding that women are twice as likely to suffer serious complications or death if they give birth by cesarean section, even if it is planned prior to labor, and they are five times more likely to have a postpartum infection. Babies, too, are more likely to die or to be so sick that they require a week-long stay in intensive care if they are not born vaginally.
The study of nearly 100,000 births excluded women or infants with underlying health complications or distress during labor so that the outcomes are associated with the method of delivery alone. Researchers found that for women undergoing cesareans, “compared with vaginal deliveries, the risk was three to five times higher for maternal death, four times higher for hysterectomy, and twice as high for being admitted to intensive care and hospital stay more than seven days.” Researchers found that infant death shortly following birth was also more likely among cesarean babies, except those who were breech* (presenting bottom-first rather than head-first).
*Of breech babies, the researchers conclude, “It is clear that these babies, regardless of gestational age, should be delivered by planned caesarean.” This statement will no doubt be challenged by researchers who have demonstrated the safety of breech birth when attended by a provider with expertise (vaginal breech birth requires special knowledge and skills). This study did not account for the qualifications of the birth attendant.