Risks of Caesarean Birth

Caesarean Birth carries many of the risks associated with common major abdominal surgery for the woman, but also has associated short and longer term risks for both mother and the baby. For women, the risks include increased possibility of immediate health complications such as hysterectomy and cardiac arrest; reduced levels of satisfaction with the birth; negative impacts on establishing breastfeeding and complications with the placenta in subsequent pregnancies. A growing body of evidence is suggesting that caesarean birth significantly changes the physiology of newborn babies, making their immediate transition to the world more difficult. There is also evidence that caesarean birth can have longer term health impacts on babies, such as increasing the risk of asthma and allergies, Type 1 Diabetes and obesity.

The risks of caesarean birth for the mother include:

• having to stay longer hospital compared with vaginal birth (NICE 2012);
• three times the risk of requiring a hysterectomy due to post-partum haemorrhage (NICE 2012);
• significant increase in the risk of cardiac arrest (NICE 2012);
• reduced levels of satisfaction with the birth (Hodnett et al. 2012);
• increased difficulties in establishing and continuing breastfeeding due to a delay in skin-to-skin contact after birth (NICE 2004, Bick 2003).
• increases the risk of women experiencing all major forms of placental disorders in subsequent pregnancies e.g. placent abruption, placenta praevia and placenta accreta (Klar et al. 2014).

The risks of caesarean birth for the baby include:

Immediate risks include:

• double the risk of the baby's admission to neonatal intensive care;
• problems with breathing;
• not as able to regulate body temperature;
• increased dificulties in establishing and continuing breastfeeding;
• alterations to the way genes in the baby's immune system express themselves;
• altered blood pressure (Hyde et al. 2012).
  

Longer-term impacts include:

• increased risk of asthma and allergies (Hyde et al. 2012), gastroenteritis (Hakansson et al. 2003), Type 1 diabetes (Cardwell et al. 2008) and obesity (Goldani et al. 2011, Huy et al. 2012)
  

• an increase in the likelihood of having a special educational need if the baby is born at aroud 37 weeks or so weeks compared to babies who are born at 40 weeks (MacKay et al. 2010).

References

• Cardwell, C.R. et al. (2008). Caesarean section is associated with an increased risk of childhood-onset type 1 diabetes mellitus: a meta-analysis of observational studies. Diabetologia. May 2008, Volume 51, Issue 5, pp 726-735.
• Håkansson S, Källén K. (2003). Caesarean section increases the risk of hospital care in childhood for asthma and gastroenteritis. Clin Exp Allergy. 2003 Jun;33(6):757-64.
• Goldani HA, Bettiol H, Barbieri MA, et al. (2011). Cesarean delivery is associated with an increased risk of obesity in adulthood in a Brazilian birth cohort study. Am J Clin Nutr. 2011;93:1344–7.
• Hodnett, E.D., Downe, S., Walsh, D. (2012). Alternative versus conventional institutional settings for birth. Editorial Group: Cochrane Pregnancy and Childbirth Group Published Online: 15 AUG 2012. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD000012.pub4/abstract
• Huy, S.Y., Rifas-Shiman, S.L., Zera, C.A., et al. (2012) Delivery by caesarean section and risk of obesity in preschool age children: a prospective cohort study. Arch Dis Child. 2012 Jul;97(7):610-6. Epub 2012 May 23.
• Hyde, M.J., Mostyn, A., Modi, N., Kemp, P.R.(2012). The health implications of birth by Caesarean section. Biol Rev Camb Philos Soc. 2012 Feb;87(1):229-43.
• Klar, M., Michels KB. (2014). Cesarean section and placental disorders in subsequent pregnancies--a meta-analysis. J Perinat Med. 2014 Sep;42(5):571-83. doi: 10.1515/jpm-2013-0199. Published online at: http://www.ncbi.nlm.nih.gov/pubmed/24566357
• NICE (2004). Caesarean Section. London: National Institute for Clinical Excellence.
• NICE (2012) Caesarean Section. NICE Clinical Guideline 132. Available online at http://www.nice.org.uk/nicemedia/live/13620/57163/57163.pdf