Caesarean section is associated with a higher risk of short and long-term problems in women and children than vaginal birth, according to new research supported by the NIHR.
C-section is a life-saving intervention for women and newborns when complications occur, such as bleeding, foetal distress, hypertensive disease, and babies in abnormal position. But, the surgery is not without risk for mother and child, and is associated with complications in future births.
In mothers, C-section is associated with an increased risk of uterine rupture, abnormal placentation, ectopic pregnancy, stillbirth, and preterm birth. And there is emerging evidence that babies born by C-section have different hormonal, physical, bacterial, and medical exposures, and that these exposures can subtly alter neonatal physiology.
Lead author Professor Jane Sandall, lead of the maternity theme at the NIHR Collaboration for Leadership in Applied Health Research and Care (CLAHRC) South London, said: “Given the increasing use of C-section, particularly cases that are not medically required, there is a crucial need to understand the health effects on women and children. Greater understanding of this is important to help inform decision making by families, physicians, and policy makers.
“C-section is a type of major surgery, which carries risks that require careful consideration. The growing use of C-sections for non-medical purposes could be introducing avoidable complications, and we advocate that C-section should only be used when it is medically required.”
The research is part of series of three papers published in The Lancet that reviews disparities in C-section use around the world, the health effects for women and children, and evidence-based interventions and actions to reduce unnecessary C-sections.
The series of papers reports that number of babies born through caesarean section around the world has almost doubled, from 12% of live births in 2000, to 21% of live births in 2015.
In the UK, C-section use has increased from 19.7% of births in 2000 to 26.2% in 2015.
The authors attributed the global increases in C-section to both more births taking place in health institutions (about two-thirds of the increase) and to greater frequency of intervention through C-section in health facilities (one-third of the increase).