Maternal Death Rate Higher for Caesarean vs. Vaginal Deliveries

March 21, 2017

There are 13 maternal deaths per 100,000 women after cesarean sections (C-sections) versus 4 maternal deaths per 100,000 women after vaginal deliveries, according to estimates by the American College of Obstetricians and Gynecologists.

Yet some critics say that U.S. doctors continue to overuse C-sections. C-sections are the most common surgical procedure in the United States, and one-third of babies are now delivered by C-section. It’s estimated that half of all C-sections are unnecessary, according to Consumer Reports.

When the World Health Organization still issued target rates, it recommended that C-sections should only make up 10 to 15 percent of deliveries. (Now, it encourages physicians to evaluate the needs of the patient on a case-by-case basis.)

Risks of a C-Section to the Mother

Like all surgeries, C-sections involve certain risks. According to The New York Times, for the mother, C-sections carry the risk of:

• Hysterectomy
• Hemorrhage
• Infection
• Deep vein thrombosis

Once a woman has a C-section, her doctor may discourage her from trying vaginal birth in later deliveries. In the state of California, for example, only 10 percent of women who have had C-sections give birth vaginally in a later pregnancy.

This is especially troubling since the risks involved in C-sections increase if a woman has multiple C-sections over her lifetime.

C-sections are also more expensive than vaginal births.

Risks of a C-Section to the Baby

Babies born by C-section are more than twice as likely to be admitted to neonatal intensive care, according to The Guardian.

C-sections also carry risk for babies later in life. A recent study shows that babies born by C-section are more likely to become obese as adults. Vaginal birth may expose babies to necessary gut bacteria that speed up their metabolism.

The difference between siblings (with the same genetics and home environment) was particularly striking: a child born by C-section is 64 percent more likely to be obese than his brother or sister born vaginally, according to The Guardian.

When a C-Section is Necessary

A C-section might be considered medically necessary if:

• Mother has a chronic health condition (e.g. diabetes or high blood pressure)
• Umbilical cord slips into the vagina
• Mother is having multiples (twins, triplets, or more)
• Baby is in breech position (bottom or feet are facing down)
• Baby is in transverse position (shoulder is facing down)
• Baby is too large to pass through the birth canal safely
• Baby is in fetal distress

Since they have a higher maternal death rate than vaginal births (among other risks), C-sections should never be done for a doctor’s convenience, but instead should only occur when medically necessary.