Risks of Having a Caesarean Birth

What are the risks of having a Caesarean birth?

Despite Caesarean birth being much safer these days it is still a ‘major’ operation. A Caesarean birth is considered major abdominal surgery and, as with other operations, there are risks involved.

The risk of a woman dying after a Caesarean birth is less than one in 12,000 (the risk of death after a vaginal birth is less than one in 10,000). The need for further surgery, such as a hysterectomy (removal of the womb) occurs more frequently after a Caesarean birth, about five per 10,000, compared to a vaginal birth (about one in 10,000). 

Infection - as with any operation there is a risk of an infection developing. After a Caesarean, common infections include urinary tract infections, (urine/water infection - one in 100) and wound infections around your scar (six in 100). Occasionally you may develop an infection in your womb (endometritis eight in 100) or bruising deep inside your tummy (haematoma). Antibiotics are given during your Caesarean birth to reduce the chance of these infections.

Blood loss - the amount of blood loss during a Caesarean birth is about twice as much as with vaginal birth. Most women who have a Caesarean birth are given iron tablets after the operation, but some women will need a blood transfusion.

Major blood loss (postpartum haemorrhage) is a rare but serious complication of childbirth occurring in about one in 100 of all deliveries, but occurs more frequently in women who have had a Caesarean birth.

Deep vein thrombosis and pulmonary embolism - being pregnant and having an operation increases the risk of developing blood clots. These blood clots can form in the veins of your legs (deep vein thrombosis) and can travel to your lungs (pulmonary embolism) causing breathing problems. To try and reduce this risk you are asked to wear special anti-embolism stockings during or immediately after the operation, which will improve the blood flow in your legs. Women with additional risk factors will also be given injections to help prevent clots forming. The overall risk of clots developing is rare but this occurs about four times more frequently following Caesarean birth than vaginal birth.

Having a scar on your womb - after having a Caesarean you will have a scar on your womb. Most of the time this will not cause you any problems. There is a very slight risk that the scar could tear (rupture) in a future labour. Uterine rupture is a rare complication but it occurs three times more frequently in women who have had a previous Caesarean birth. A scar on your womb also increases your chances of having a placenta praevia after birth situated low in the womb to about six in 1000, or a placenta acreta (placenta that will not separate from the womb).

Risk of damage to other organs - very rarely other organs, such as your bladder or bowel may be injured during the operation. The risk of bladder and urinary tract injuries are about one in 1,000 with Caesarean birth compared with one in 10,000 with vaginal birth. Birth canal injury is as likely with a Caesarean birth as a vaginal birth. Faecal incontinence (not having control over passing stools) is also as likely following a Caesarean birth as after a vaginal birth. This is more common if you have had a Caesarean birth before, because the operation is slightly more difficult due to scarring.

Are there any risks to my baby?

Breathing problems - the risk of your baby developing breathing problems is increased if your baby is born at less than 38 weeks. Therefore most Caesareans are done in the 39th week because at this time your baby will have fully developed lungs. Occasionally women who are having an elective Caesarean birth go into labour before the planned date.

Baby injury - although rare, the surgeon can accidentally cut the baby’s skin surface while making the incision. This is usually during emergency Caesareans. These cuts are usually superficial, normally heal very well and seldom cause long term scarring.