Pregnant women, particularly older mothers, are more at risk of experiencing complications during cesarean deliveries, a new study reveals.
The World Health Organization has warned that cesarean deliveries, or C-sections, must only be used in life-threatening cases due to risks of complications. However, C-sections have been steadily increasing, without significant benefits to the health of mothers or their babies.
An estimate of one in five pregnant women gives birth through C-sections in developed countries. Many cesarean sections are undertaken unnecessarily and this can put the lives and well-being of women and their babies at risk, both in the short-term and the long-term.
Complications Of C-Sections
The researchers performed a case-control analysis using data from EPIMOMS, a prospective population-based study of deliveries at 22 gestation weeks or later from six regions of France from 2012 to 2013.
Among the 182,300 deliveries examined, the researchers identified 1,444 cases of C-section deliveries and 3,464 cases of vaginal births.
While C-sections can be considered as life-saving, the procedure also carries risks such as infection, excessive bleeding, damage to reproductive organs, and blood clots.
The research found that women who had C-section deliveries are 80 percent more likely to have complications compared to women who delivered via vaginal birth. The risk of complication from C-sections also increases with maternal age, particularly for women aged 35 years and older.
Women who give birth at the age of 35 and older through cesarean are almost three times more likely to experience severe complications. The main cause of such complications is major hemorrhage or bleeding after delivery.
"Overall, delivery is safe. However, in a minority of cases, severe complications can occur in the mother during or soon after the delivery," said Dr. Catherine Deneux-Tharaux, senior study author of INSERM in Paris.
Cesarean delivery also accounts for a higher risk of severe complications. In the study, 36 percent of the mothers who had severe complications delivered by C-section.
According to Deneux-Tharaux, as women age, the uterine muscles lose their ability to efficiently contract, and this can contribute to heavy bleeding after C-sections among older women.
Higher Risks For Older Women
The study highlights the importance of judicious C-section decision-making, especially for women 35 years and older who may have additional pregnancies.
Women aged 35 and older who gave birth through C-section after going into labor are said to be four times more at risk of having complications than mothers over 35 who had vaginal births.
Mothers 35 and older who had C-sections without first going into labor are five times more likely to experience severe complications than mothers who had vaginal births.
"The risks of cesarean delivery accumulate over a woman's lifetime, with a first cesarean increasing risks in subsequent pregnancies, increasing likelihood of a second C-section, and increasing complications in that second cesarean," said Laura Schummers from the University of British Columbia in Vancouver who was not involved in the study.
In 2018, the WHO issued guidance on non-clinical interventions focusing on reducing unnecessary cesarean sections.