Mortality rate of a c section

[anonny55]

C section - 1 in 4200
Vaginal birth - 1 in 25000

Mums who had an elective c section, did this not freak you right out? It's the only thing putting me off. It seems high!

Also, did your baby need time in the nicu as there's also higher rate of babys needing neonatal care from c section births.

No didn't freak me out at all, didn't need NICU either.
Sometimes it's best to stay away from the internet and stats and just get on with life.

No and no. The consultant told
me she wished they didn’t put risk of death on the form I had to sign and said you’re not going to die.

It's not really a good statistic. If you go into hospital with reduced movements and baby is in trouble they don't induce a vaginal birth, they do a c section. The c section rate will include crash c sections, EMCS where vaginal birth gone wrong etc. Babies born super early due to complications at 32 weeks etc also likely c section and obviously need NICU.

It's similar with saying how safe home births are. Most of the ones that had issues were identified by the well trained midwives and transfered to hospital before the birth so becomes a hospital statistic.

4 sections here and yes, I was aware that it was higher risk. I desperately wanted to have a natural birth.

Where did you get these stats from?

But most CS are done because there are problems.

You need to compare elective CS rares with 'normal' vaginally births.

Almost all births with issues will be a c section I would think. So those births with issues will be part of the c section statistic.

I would have loved a vaginal birth but neither me or any of my 3 babies would have survived without a c section, so it was the best option!

Also if you Google - not all deaths relating to sections have anything to do with the actual operation itself. So the actual mortality rate is lower than many figures you see.

Emily Oster's book is great - Expecting Better
She talks through a lot of this data and explores it
Like with the c section data the surgery is often because there's already developing issues - it's not just ' I fancied it'. Does that also include emergency crash sections too? Vaginal births going wrong are more likely to become c sections; what do they get categorised as?

Also….with a section your risk of pelvic floor issues after is lower. And no tears/incontinence from them.
Also less chance of needing a hysterectomy

False comparison

As far as I understand it, CS stats include both emergency CS and elective/planned CS. The emergency ones will cover all manner of complications, as PPs have said. Elective or planned CSs are very very safe - I’ve seen stats to say it’s the safest method of delivery for mums and babies after an uncomplicated vaginal delivery (but you can’t choose one of those). I had a planned CS 9 weeks ago today due to my DS being breech and honestly, it was genuinely a lovely experience. I’m more than happy to talk about it via DM if that’s helpful or reassuring at all 😊

Is that the rate for maternal choice c sections or all of them including emergencies?

I had an emergency which ended up being under GA and my second was “elective” but medically obligatory and at 37 weeks because of issues caused by the first one. They both had things go very wrong but I and both babies were okay, no NICU and I was able to breastfeed. I’d far rather have had vaginal births but my babies weren’t coming out without surgery so what can you do.

Straight forward electives, no complications, mum not exhausted from being in labour, probably low rates of drama and poor outcomes.

Just to add, EMCS after attempt at natural delivery here. 100% my baby would have died if I'd tried to go for vaginal any longer, baby was getting so stressed their heart rate was dropping below 70 and stopped coming back up. C section meant my baby was born completely healthy. No NICU, no issues establishing breastfeeding and exclusively breastfed for over a year.

In 15 primary randomized controlled trials, 3265 patients were randomized to planned cesarean delivery and 3353 to planned vaginal delivery. The incidence of perinatal deaths was not different (1.3% vs 1.3%; relative risk, 0.71; 95% confidence interval, 0.33–1.52). Planned cesarean delivery was associated with lower neonatal incidences of low umbilical artery pH (0.3% vs 2.4%; relative risk, 0.18; 95% confidence interval, 0.05–0.67), birth trauma (0.3% vs 0.7%; relative risk, 0.46; 95% confidence interval, 0.22–0.96), tube feeding requirement (2.5% vs 7.1%; relative risk, 0.36; 95% confidence interval, 0.19–0.66), and hypotonia (0.4% vs 3.5%; relative risk, 0.11; 95% confidence interval, 0.03–0.47), compared to planned vaginal delivery. Chorioamnionitis was less frequent in the planned cesarean delivery group (0.3% vs 1.0%; relative risk, 0.27; 95% confidence interval, 0.08–0.98). Wound infection was more common in the planned cesarean delivery group (1.9% vs 1.1%; relative risk, 1.61; 95% confidence interval, 1.04–2.52). Lower rates were observed in the planned cesarean delivery group for urinary incontinence at both ≤3 months (8.7% vs 12.2%; relative risk, 0.71; 95% confidence interval, 0.59–0.85) and 1 to 2 years (16.9% vs 22%; relative risk, 0.77; 95% confidence interval, 0.67–0.88) and for a painful perineum at 2 years (4% vs 6.2%; relative risk, 0.64; 95% confidence interval, 0.47–0.87) compared to planned vaginal delivery. Among singleton pregnancies, planned cesarean delivery was associated with a lower rate of perinatal death (0.69% vs 1.81%; relative risk, 0.45; 95% confident interval, 0.21–0.93).

Not really, DC's likelihood of survival (in our circumstances) was much higher then if I had tried for a virginal delivery, my babies safety was and is more important to me then a very small increase in my own risk.

The statistic for needing NICU is also a little misleading, as mothers of babies who are struggling and so likely to need NICU (eg. due to medical issues during pregnancy) are more likely to be advised to have a section, as it's less stress on the baby and gets them to the needed medical care as quickly as possible.

In summary:

Planned cesarean delivery and planned vaginal delivery were associated with similar rates of perinatal and maternal mortality in this meta-analysis of randomized controlled trials. Planned cesarean delivery was associated with significant decreases in adverse neonatal outcomes such as low umbilical artery pH, birth trauma, tube feeding requirement, and hypotonia, and significant decreases in chorioamnionitis, urinary incontinence, and painful perineum. Planned vaginal delivery was associated with significant decreases in need for general anesthesia and wound infection. Further randomized trials are needed to assess the risks and benefits of planned cesarean delivery vs planned vaginal delivery in lower-risk patients and in the general population.

No. It didn't freak me out or bother me at all.

My own c-section was an emergency one because DD3 just wasn't coming out unharmed any other way. Without the c-section she would certainly have died, with a high chance of taking me with her.

I've had both vaginal and caesarean deliveries. I had complications with both and suffered birth injuries. I will be honest now and say that if I could have my time again I would insist on all three being delivered by c-section.

it would be more accurate to look at statistics of your actual situation- age, pregnancy issues and whatever else. So often the ‘overall’ figures just aren’t relevant at all.

It isn't that choice, more likely you need one because you or baby are ill.

I’m not sure this statistic is true. About 31% of UK births are c- section and mortality in pregnancy upto 40 days after is about 250-300 over 3 years. Which is way less than 1 in 4200.

I nearly died with my first vaginal delivery. And I was very very lucky not to be rendered incontinent - and to still be able to enjoy sex. I suspect my subsequent c-sections were recorded as "elective" but my obgyn agreed with me that I should not attempt another vaginal delivery.

My consultant.

Well no. A lot of the time a c section is required because it is an emergency, so it is more likely there is a higher risk of mortality. Bandying about statistics without context is foolish and shit stirring for no good reason. Without a c section both my DD and I would have died in childbirth.