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.

How does it class births that started vaginal but ended in a c-section?

Because I imagine the majority of vaginal births that end in a death will have turned into a c section, because a problem will be detected and they'll hit the emergency button and get the baby out ASAP. Obviously not all, but I mean if they're monitoring the baby's heartbeat and suddenly it's very worrying, they'll rush you in for a c section. So would that be a c section stat?

Yes these aren't comparable.

Im having a second maternal request plan c and your reading it as

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

The actual scenario is;

ALL C sections (emergency, indicated elective and choice maternal request including the ones done by knackered junior doctors in the middle of the night after a 13 hour shift) - 1 in 4200

VS. SUCCESSFUL Vaginal birth - 1 in 25000 (successful is only 2/3rds to 50% of those who attempt vaginal labour and successful here includes everyone who pushed a baby out regardless of the outcomes; ie. from those haemorrhaging, to those with tears, to those with a ruptured uterus from VBAC)

When you compare stats for non indicated maternal request c sections vs all other births then thats when c section stats actually come out as a better choice on average.

Hard to find those stats though as the comparisons can be complicated.

No because my baby would have died during vaginal birth

Are you sure you heard the stat correctly from your consultant. That’s a generic google AI stat. Elective sections are marginally the safest delivery option for the baby. Your consultant should know this.

It's been said but those statistics are just indicative that c sections are often performed due to a trauma or pre-disposed potential danger either pre labour or during labour. There is already an issue usually, even in electives (multiple pregnancies, placental issues etc) that skews the results. It's like saying hospital admissions are higher in a war zone compared to a peaceful country. It is a fact but it doesn't have anything to do with the other.

Any intervention can add the risk, infection etc but it depends how successful a vaginal birth would be too. I had an emergency section because my 11 day overdue 10lbs baby was stuck and not effaced, would never have been able to push him out and in the past would have been a statistic for a death via vaginal birth if an emergency section didn't exist, it just really depends.

These stats really mean nothing without explanation. If they were all first time mums who just liked the idea of a c-section, yes they are scary. However I would imagine that they cover ANY planned C-section. So I would imagine those stats cover mums who had had health problems earlier in pregnancy, whose babies had already been diagnosed with a medical condition in the womb, who had a history of traumatic birth or poorly, disabled babies or those sadly incompatible with life. Of course, one of the main ways of getting poorly babies out fast will result in more care needs and tragedy than the way most healthy babies are born.

Those figures include elective and emergencies. There is not a true comparison.
Compare the injury rates, especially pelvic floor injuries too for a more balanced comparison.

Risks: (Numbers quoted below are estimates
Planned caesarean birth
only based on the data currently avallable)
Perineal tears (third-and-fourth-degree) O per 100000
Urinary incontinence occurring > 1 year
27 520 per 100000 (about 1 in 4)
after birth
Faecal incontinence occurring > 1 year
7410 per 100000 (about 1 in 13)
after birth
Urinary tract injury
Risk of bowel injury
Wound infection, which may require
About 1 per 1000"
1 in 2000
2-7 per 100 (about 1 in 14-50)
readmission to hospital for treatment
Hospital stay
Uterine rupture in future pregnancy or birth
About 4 days on average
1020 per 100000 (about 1 in 98)* Risk Is higher after multiple caesarean births and after emergency caesarean than after planned caesarean births
Emergency hysterectomy: removal of
150 per 100000 (about 1 in 670)
your uterus
Placenta accreta spectrum
100 per 100000 (1 in 1000)*
(abnormally adherent or invasive
Risk is higher after multiple caesarean
afterbirth) in future pregnancy
births and after emergency caesarean than after planned caesarean births
Maternal death (death within 6 weeks
24 per 100000 (about 1 in 4200)
of childbirth)
Risks associated with anaesthesia
As discussed with the anaesthetist
Skin lacerations/cuts
Risks for
1-2 per 100
the baby
Childhood obesity
4560 per 100000 (about 1 in 22)
Asthma
1810 per 100000 (about 1 in 55)
Higher neonatal mortality (death of
50 per 100000 (1 in 2000)
babies within 28 days of birth)
*Figures based on planned and unplanned caesarean births
Planned vaginal birth
560 per 100000 vaginal births (about 1 in 179)
48700 per 100000 (about 1 in 2)
No difference for unassisted vaginal birth 15100 per 100000 for assisted vaginal birth (about 1 in 7)
O per 1000
O per 2000
Infection rates of perineal tears or episiotomy ranges from less than 1 per 100 to 13 per 100, but readmission is less likely About 2 and a half days on average 40 per 100000 (1 in 2500)
Risk is higher for planned vaginal birth in women who have had up to and including four caesarean births
80 per 100000 (1 in 1250)
40 per 100000 (1 in 2500)
4 per 100000 (1 in 25 000)
Up to 10 per 100 with assisted vaginal birth
4050 per 100000 (about 1 in 25)
1500 per 100000 (about 1 in 67)
30 per 100000 (about 1 in 3300)

Just took this photo of the paper I was given and copied and pasted from the photo. Please read exactly what I wrote. No I didn't make up my own words. Thanks

Thank you. That is exactly the same as the piece of paper with a chart looking lay out reads. There wasn't anything else other than that wrote about it and it scared me a little. Jesus some people!

@stichguru thanks for that

That rate surely needs to be put in context - I’m not a medic but I’d suggest a large proportion c-section births are not elective & are conducted in births with complications and therefore are higher risk anyway. If those c-sections hadn’t been conducted those deaths could have been attributed to natural births? I speak as someone who had two emergency c-sections which I am hugely thankful for. Without them neither I or my babies would have survived.

This is the thing around stats you need the context around in.
As people have said it is difficult to compare all c-sections with vaginal birth. Elective c-sections maybe that would be a better comparison. But all c-sections would include the most risky births a lot of which will have started off as a vaginal birth and then something has gone wrong.

Agree

Unnecessary post

I now understand this. Thanks!

I think you have misunderstood the stats. It’s 5.9 per 100,000 births in the UK for elective c sections.

https://pmc.ncbi.nlm.nih.gov/articles/PMC343856/

As Pp have said, you need to control for the fact that some women have emergency CS because they have another condition that is life threatening, it’s not the CS that cause the increased risk.

A randomised control trial ( where women were randomly allocated to CS or vaginal delivery ) showed no significant extra risk of maternal death or serious maternal morbidity .

@Pigsinblankets13 I'm glad you think so. You can always scroll by if you feel it's unnecessary that an expecting mother with a choice on her hand to birth her baby in the safest way possible is trying to discuss a statistic given to me from the nhs.

Ffs. I repeat. This is what was wrote on the paper given to me by the consultant. It also has 'planned caesarean birth' wrote as the heading. This is not just some shit I wrote online and interpreted into my own words or misread.

First mistake. Trusting your consultant without researching it. They get pulled up on the number of elective sections they do.

Doctors arent always right and very clearly yours was far from right. Anyone can work out that statistically at a basic level c sections will result in a higher rate of maternal mortality as c sections are offered more readiliy and encouraged for higher risk women. Your consultant knows this. They just don't want to do one as it acrews their numbers ans they're trying to put you off.

Its the same as if you looked up statistics for paedatic mortality you'll likely find trusts with a PICU and specialist services have a higher mortality rate. Are they more unsafe? No just different patient high risk patient group.

Childbirth however you do it has risks. Choose the risks that suit you best. In hindsight i'd have gone straight for an elective section which is what i'd have preferred. If i had another i'd have an elective section and wouldn't even consider anything else. Elective sections are way better than emergencies.

This is why statistics without context are misleading and can sometimes be dangerous. The majority of those having an elective section will have a level of risk that has led to this decision. This is what is not being taken into account in your table. You need to at the stats between women who have no underlying issues and compare elective and vaginal. These stats have shown elective is marginally safer.

In case you didn't realise ... You're not the first woman to be an expectant mother with this decision to make. You could have approached it with more sensitivity...I suppose you're one of them that also thinks a C-section is an easy way to have a child. Bye

@Antsinmypantsneedtodance
I feel elective c section may be the safest option for me but from the sheet of paper I was given (uploaded it a few comments before this) the only thing that threw me off was the maternal death rate hence why wondering if anyone wasn't put off by that. I understand if your baby would've died if you didn't have a cs of course you wouldn't give a shit and would do it no matter the risk (well I would) It's a little different for me. I'm at risk of shoulder distocia hence being offered the c section if id like one. It may or may not happen so I'm tossing between a c section for something that might happen but it might not happen or induction and it does happen and that would be extremely scary and may end in emcs.

I felt really pushed by the consultant that a c section was the best choice for me so I don't think she was trying to scare me, I think I was more scared being told his head could deliver and he'll be stuck like that and require instrumental intervention or an emcs due to his size! I think this piece of paper is probably given to all mothers tossing between induction or cs..

@Pigsinblankets13 are you stupid? Where did I say it's the easy way out? I actually don't think it is at all. My close friend had to have an emcs due to shoulder dystocia and it was all very traumatic for her. I've seen first hand someone struggle after having a cs. Bye too.

No, it didn't freak me out. Are you sure that's the correct stat, though?

My baby would have died if I hadn't had a C section, so I had no choice. She didn't need NICU either. The vast majority of babies born by CS, especially elective CS, don't.

I get it OP.

But on baby no 1 they fire all this stuff at you and try to tell you how awful it is.

On baby no 2 they are like what do you want to do? And your sitting their laughing with the consultant about how vaginal labours should have two pieces of paper; the natural one plus the one you have been given. Because really there's a 30-50% chance that vaginal labours ending in a C anyway.

The TDLR is there's no good way to have a baby. It's a flawed system but in all likelihood your going to be fine.