While C-section rates continue to rise around India and globally, women’s health activists are struggling to raise awareness among patients about the risks inherent in surgical deliveries. In India, C-sections are too often framed as the more convenient and predictable, less risky of the two options for delivery. And yet, a new review of the literature on risks and benefits of Cesarean sections, conducted by Sarah Stock from the MRC Centre for Reproductive Health at the University of Edinburgh, UK, and published this week in PLOS Medicine, paints a different picture.
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The large-scale review of global data found that compared with vaginal deliveries, Cesarean deliveries were found to be associated with a decreased risk of urinary incontinence and pelvic prolapse. That’s the good news. But children delivered by C-section had an increased risk of asthma for up to 12 years and obesity up to age 5. And pregnancy after Cesarean delivery was associated with an increased risk of miscarriage, stillbirth, placenta previa, placenta accreta, and placental abruption, which means first-time mothers, in particular, might benefit from having these risks spelled out clearly.
Unfortunately, the authors of the review were not able to segregate the results by which Cesarean sections were elective versus which were medically necessary. However, the results could provide a helpful and objective assessment of the global risk factors involved in choosing C-sections over vaginal deliveries where patients do have a choice.
“This information should help inform discussions about mode of delivery, and may facilitate appropriate personalized delivery planning and shared decision making,” the researchers say.
In a medical culture that prizes predictability, it’s particularly important that patients remain fully informed of the risks of the procedures that they’re choosing. Informed consent is an integral part of any patient’s rights, particularly if the risks of a procedure are so well-documented.
