Cesarean Section: Myth versus Reality



Out of concern for rising cesarean rates and reduced access to vaginal birth after cesarean (VBAC), Childbirth Connection carried out a systematic review of several hundred studies that compared harms of cesarean and vaginal birth. The evidence is clear: unless there is a compelling and well-supported reason for cesarean section, vaginal birth is the safest way for women to give birth and babies to be born. (See links below to learn more about review results.)

MYTH: The belief that cesarean section is safe.

REALITY: Vaginal birth is far safer overall for mothers and babies. Although cesarean section is safer now than in the past, it is major abdominal surgery and poses many extra risks for mothers and babies in comparison with vaginal birth.

MYTH: The belief that planned ("elective") cesarean is an optimal solution for mothers and babies.

REALITY: Although planned cesarean is very convenient for busy hospitals and caregivers, vaginal birth is far safer overall for mothers and babies.

MYTH: The belief that vaginal birth is harmful for mothers and babies.

REALITY: Vaginal birth is far safer overall for mothers and babies than cesarean section. Some common overused obstetric practices, such as making a cut to enlarge the vagina (episiotomy) or forceful staff-directed pushing, can harm women and should be avoided.

MYTH: The belief that a healthy woman who has a cesarean will avoid incontinence later in life

REALITY: Current research suggests that this will have no effect on later-life incontinence. Having an unneeded cesarean poses plenty of risks and no clear benefits. Women who wish to avoid or limit incontinence would be wise to take other steps, such as maintaining a healthy body weight, avoiding or quitting smoking, avoiding or quitting hormone therapy, and carrying out a rigorous program of pelvic floor muscle exercises ("Kegels").

What is important for pregnant women to consider?

Women need full and accurate information well before labor about what is at stake in decisions about how to give birth. To learn about more about Childbirth Connection's review, see
"Practice style" (and propensity to use maternity interventions) varies widely among providers and birth settings. Choosing a maternity caregiver and place of birth are two of the most important decisions that will influence the care a woman receives.

Childbirth Connection's message to women is:
  • BE INFORMED.
  • KNOW YOUR RIGHTS
  • PROTECT YOURSELF AND PROTECT YOUR BABY.
  • BE AN ADVOCATE FOR SAFE, EFFECTIVE AND SATISFYING CARE FOR YOU AND YOUR BABY. YOUR EFFORTS WILL BENEFIT OTHER WOMEN AS WELL.

© 2014 Childbirth Connection. All rights reserved.

Childbirth Connection is a national not-for-profit organization founded in 1918 as Maternity Center Association. Our mission is to improve the quality of maternity care through research, education, advocacy and policy. Childbirth Connection promotes safe, effective and satisfying evidence-based maternity care and is a voice for the needs and interests of childbearing families.
Most recent page update: 2/9/2006