An analysis of 3.5 million US birth certificates has confirmed that c-sections carry a higher risk for women than vaginal birth.

The Centers for Disease Control and Prevention (CDC) reviewed maternal morbidity data from 2013 (90% of all US births for that year) and found that admission to intensive care units and blood transfusions are more common after first time c-sections than after vaginal birth or repeat c-sections.

An article published in the National Vital Statistics Report also found c-sections are causing more uterine ruptures and unplanned hysterectomies, reaffirming that vaginal birth is much safer than c-sections. The report emphasises the concern about the high rate of c-sections in the US, which accounts for almost 33% of all live births (similarly to Australia).

Women who underwent a primary (first time) c-section were three times more likely to have blood transfusions than those who had vaginal births with no previous c-sections. The study also revealed women who had c-sections were six times more likely to require admission to intensive care units.

Unplanned hysterectomy rates were over five times more likely to occur in women with c-sections than vaginal births. Uterine rupture occurred at a rate of 26 in 100,000 births. Women who had repeat c-sections had the highest rates of uterine rupture and unplanned hysterectomy (88.9 per 100,000 and 143.1 per 100 000 respectively).

Curtin and her fellow authors noted in the study: “Higher rates of maternal morbidity for cesarean compared with vaginal deliveries were found for nearly all maternal age groups and for women of all race/ethnicities.”

Of those women who had a previous c-section, 20% choose a vaginal birth for their next pregnancy and 70% had a successful outcome. The CDC report states: ‘Women with a previous Caesarean delivery who laboured and had vaginal birth generally had lower rates for most morbidities.’

The WHO released a statement in April 2015 commenting that when a country’s caesarean rate is above 15%, the dangers of the surgery actually outweigh the life-saving benefits. The US and Australian c-section rate is double the ‘medically necessary’ target of 10-15% that the WHO recommends. When c-sections are performed without medical need, mothers and babies are at increased risk of complications and future health problems.

The CDC report notes that ‘Given the lower morbidity for vaginal compared with Caesarean deliveries, attempting a trial of labour is recommended for most women with no previous Caesarean as well as for low-risk women with a previous Caesarean delivery.’

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