Caesareans Risky, Researchers Find
October 31st 2007
In most cases caesarean births raise the risk of death and complications for both mother and baby, researchers warned today. 
This is the conclusion of a new study carried out by Dr Jose Villar of Oxford University, UK and colleagues. The team took data from a 2005 World Health Organisation survey, in order to assess the risks and benefits of caesarean versus vaginal delivery.
The information came from 97,095 deliveries in eight Latin American countries. The authors report in the British Medical Journal on-line that the risks were approximately doubled.
They write: "Women undergoing caesarean delivery had an increased risk of severe maternal morbidity compared with women undergoing vaginal delivery."
The need for neonatal intensive care was higher, and antibiotic treatment after delivery was five times more common after a caesarean, they add. But babies born in the breech position were much safer when born by caesarean. They were much less likely to die during birth and up to hospital discharge.
The authors conclude: "Caesarean delivery independently reduces overall risk in breech presentations and risk of intrapartum foetal death in cephalic presentations [head first] but increases the risk of severe maternal and neonatal morbidity and mortality in cephalic presentations."
They believe that, apart from breech presentations, "any net benefit from the liberal use of caesarean delivery on maternal and neonatal outcomes remains to be demonstrated".
An accompanying editorial says that better risk estimates are needed. Dr Allison Shorten of the University of Wollongong, Australia states: "Future work should help to establish a consistent set of probabilities for the range of outcomes according to these factors, to support practitioners who guide and inform individual women’s birth decisions."
Villar, J. et al. Maternal and neonatal individual risks and benefits associated with caesarean delivery: multicentre prospective study. The British Medical Journal, published online October 31, 2007.
Shorten, A. Maternal and neonatal effects of caesarean section. The British Medical Journal, published online October 31, 2007.
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