The Risks of Birth by Cesarean Section

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When a cesarean section is performed, the risks and benefits of the procedure need to be considered and weighed. This process includes looking at the added benefits and potential risks of birthing a child by c-section compared to vaginally.

Sometimes, the benefits of the cesarean birth will outweigh the risks, and sometimes, the vaginal birth benefits will outweigh the risks of the cesarean birth. The best option varies on an individual basis. You should consult a doctor if you are seeking advice about a potential cesarean birth.

Cesarean Surgery

Cesarean birth is major surgery, and, as with other surgical procedures, there are risks involved. The estimated risk of a woman dying after a cesarean birth is higher than the risk of death after a vaginal birth, but it is still considered a rare event. Individual medical conditions, such as some serious heart problems, may require a cesarean birth or modifications to the vaginal delivery, such as the use of vacuum or forceps.

Risks to the Mother

Other potential risks for the mother include the following:

  • Decreased bowel function. The bowel sometimes slows down for several days after surgery, resulting in distention, bloating and discomfort.
  • Increased blood loss. Blood loss on the average is about twice as much with cesarean birth as with vaginal birth. However, blood transfusions are rarely needed during a cesarean.
  • Increased risk of deep vein thrombosis (DVT).
  • Increased risk of placenta previa and placenta accreta in future pregnancies.
  • Infection. Infection of the surgical site, the uterus or nearby pelvic organs such as the bladder or kidneys can complicate the postpartum/post-surgical experience.
  • Longer hospital stay and recovery time. Three to five days in the hospital is the common length of stay, whereas it is less than one to three days for a vaginal birth.
  • Maternal death (very rare).
  • Potential decrease in future fertility.
  • Reactions to anesthesia. The mother's health could be endangered by unexpected responses (such as blood pressure that drops quickly) to anesthesia or other medications during the surgery.
  • Risk of additional surgeries. For example, hysterectomy, bladder repair, etc.
  • Risk of adhesions.
  • Risk that all future births may be surgical.

Risks to the Baby

In cesarean birth, there are potential risks for the child as well as for the mother. Possible risks to the baby include the following:

  • Breathing problems. Babies born by cesarean are more likely to develop breathing problems such as transient tachypnea (abnormally fast breathing during the first few days after birth).
  • Fetal injury. Although rare, the surgeon can accidentally nick the baby while making the uterine incision. (Note that fetal injury can happen with vaginal delivery as well.)
  • Increased risk of asthma in babies born via cesarean section.
  • Low Apgar scores. Babies born by cesarean sometimes have low Apgar scores. The low score can be an effect of the anesthesia used during cesarean birth (particularly when general anesthesia is used), or the baby may have been in distress to begin with and that was why the cesarean was performed.
  • There is also emerging research that talks about the increased risks of some diseases and conditions including asthma, allergies, ADHD, and autism from the lack of exposure to vaginal flora. To help decrease this risk, some practitioners are recommending a procedure called vaginal seeding for cesarean born babies.

A Word From Verywell

Remember that simply because there is an increased risk does not mean that you are likely to have problems. The true risk any particular patient faces depends on numerous factors that we can't figure out in an article.

This is where talking to your practitioner, going over your medical records, and discussing your particular medical history and situation is really important for the health of you and your baby. With their help, you can figure out what risks are more likely for you and what the best delivery method is for you and your baby.

4 Sources
Verywell Family uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Keag OE, Norman JE, Stock SJ. Long-term risks and benefits associated with cesarean delivery for mother, baby, and subsequent pregnancies: Systematic review and meta-analysis. PLoS Med. 2018;15(1):e1002494. doi:10.1371/journal.pmed.1002494

  2. Elkayam U, Goland S, Pieper PG, Silverside CK. High-risk cardiac disease in pregnancy: part I. J Am Coll Cardiol. 2016;68(4):396-410. doi:10.1016/j.jacc.2016.05.048

  3. Mylonas I, Friese K. Indications for and Risks of Elective Cesarean Section. Dtsch Arztebl Int. 2015;112(29-30):489-95. doi:10.3238/arztebl.2015.0489

  4. Rafiei M, Saei ghare M, Akbari M, et al. Prevalence, causes, and complications of cesarean delivery in Iran: A systematic review and meta-analysis. Int J Reprod Biomed (Yazd). 2018;16(4):221-234.

Additional Reading
  • Silver et al, Maternal Morbidity Associated With Multiple Repeat Cesarean Deliveries, Am J Obstet Gynecol 2006; VOL. 107, NO. 6.

  • Centers for Disease Control and Prevention: Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion. Pregnancy Mortality Surveillance System. January 31, 2017.

  • MacDorman, M. F., Declercq, E., Cabral, H., & Morton, C. (2016). Is the United States Maternal Mortality Rate Increasing? Disentangling trends from measurement issues Short title: U.S. Maternal Mortality Trends. Obstetrics and Gynecology, 128(3), 447–455.

  • Mercer et al, Labor Outcome With Repeated Trials of Labor Am J Obstet Gynecol 2008;VOL. 111, NO. 2, PART 1.

  • Roduit C, Scholtens S, de Jongste JC, Wijga AH, Gerritsen J, Postma DS, Brunekreef B, Hoekstra MO, Aalberse R, Smit HA. Asthma at 8 years of age in children born by caesarean section. Thorax. 2009 Feb;64(2):107-13. Epub 2008 Dec 3.

  • Romano-Keeler, J., & Weitkamp, J.-H. (2015). Maternal influences on fetal microbial colonization and immune development. Pediatric Research, 77(0), 189–195.

  • Song, S. J., Dominguez-Bello, M. G., & Knight, R. (2013). How delivery mode and feeding can shape the bacterial community in the infant gut. Canadian Medical Association Journal, 185(5), 373-374. doi: 10.1503/cmaj.130147

  • Zuarez-Easton, S., Zafran, N., Garmi, G., & Salim, R. (2017). Postcesarean wound infection: prevalence, impact, prevention, and management challenges. International Journal of Women’s Health9, 81–88.

  • American College of Obstetricians and Gynecologists (2000; reaffirmed 2003). Scheduled cesarean delivery and the prevention of vertical transmission of HIV infection. ACOG Committee Opinion No. 234. Washington, DC: American College of Obstetricians and Gynecologists.
  • Cunningham FG, et al. (2005). Cesarean delivery and peripartum hysterectomy. In Williams Obstetrics, 22nd ed., pp. 587–606. New York: McGraw-Hill.
  • Kolas T, et al. (2006). Planned cesarean versus planned vaginal delivery at term: Comparison of newborn infant outcomes. American Journal of Obstetrics and Gynecology, 195(6): 1538–43.
  • Lee YM, D'Alton ME. Cesarean delivery on maternal request: maternal and neonatal complications. Curr Opin Obstet Gynecol. 2008 Dec;20(6):597-601. Review.
  • Lydon-Rochelle M, et al. (2000). Association between method of delivery and maternal rehospitalization. JAMA, 283(18): 2411–2416.
  • Porter TF, Scott JR (2003). Cesarean delivery. In JR Scott et al., eds., Danforth's Obstetrics and Gynecology, 9th ed., pp. 449–460. Philadelphia: Lippincott Williams and Wilkins.

By Robin Elise Weiss, PhD, MPH
Robin Elise Weiss, PhD, MPH is a professor, author, childbirth and postpartum educator, certified doula, and lactation counselor.