Book
Recommendations on The Clinical Interventions For The Prevention of The Primary Cesarean Section
- Appendices
Appendix I: Benefits And Risks of Vaginal and Caesarean Birth
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Outcomes |
Risk with vaginal birth |
Risk with caesarean birth |
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Outcomes for women that may be more likely with caesarean birth |
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Peripartum Hysterectomy |
100 / 100,000 would be expected to have a peripartum hysterectomy |
200 / 100,000 would be expected to have a Peripartum hysterectomy |
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Maternal Death |
4 / 100,000 would be expected to die |
25 / 100,000 would be expected to die |
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Placenta Accreta In Any Future Pregnancy |
30 / 100,000 would be expected to have a placenta accreta in a future pregnancy |
100 / 100,000 would be expected to have a placenta accrete in a future pregnancy |
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Uterine Rupture In Any Future Pregnancy |
7 / 100,000 would be expected to have a uterine rupture in a future pregnancy |
200 / 100,000 would be expected to have a uterine rupture in a future pregnancy |
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Outcomes for babies that may be more likely with caesarean birth |
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Neonatal Mortality |
30 / 100,000 would be expected to die |
85 / 100,000 would be expected to die |
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Asthma |
1,500 / 100,000 children would be expected to have asthma |
1,809 / 100,000 children would be expected to have asthma |
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Outcomes for women that may be less likely with caesarean birth |
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Urinary incontinence occurring more than 1 year after birth compared to unassisted and assisted vaginal birth |
48,700 / 100,000 women would be expected to have urinary incontinence (unassisted vaginal birth) 19,800 / 100,000 women would be expected to have urinary incontinence (assisted vaginal birth) |
19,600 / 100,000 women would be expected to have urinary incontinence 7,300 / 100,000 women would be expected to have urinary incontinence |
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Faecal incontinence occurring more than 1 year after birth; compared to assisted vaginal birth |
15,100 / 100,000 women would be expected to have faecal incontinence after assisted vaginal birth |
7,800 / 100,000 women would be expected to have faecal incontinence |
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Vaginal tear |
560 / 100,000 women would be expected to have a vaginal tear |
0 / 100,000 women would be expected to have a vaginal tear |
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Perineal/abdominal pain during birth and 3 days after birth |
Median pain scores of 7.3 (during birth) and 5.2 (3 days after birth), 1 is no pain, 10 is most severe pain |
Median pain scores of 1.0 (during birth) and 4.5 (3 days after birth) |
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Outcomes for women and babies that are likely to be similar for caesarean or vaginal birth |
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Outcomes for women |
Outcomes for babies/children |
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• thromboembolic disease • major obstetric haemorrhage • postnatal depression • faecal incontinence (occurring more than 1 year after birth; compared to unassisted vaginal birth) |
• admission to neonatal unit • infection • persistent verbal delay • infant mortality (up to 1 year) |
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Outcomes for women and babies that have conflicting or limited evidence about the risk with caesarean or vaginal birth |
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Outcomes for women |
Outcomes for babies/children |
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• ITU admission • stillbirth in a subsequent pregnancy. |
• respiratory morbidity • cerebral palsy • obesity (childhood) • autism spectrum condition • type 1 diabetes. |
Source: Adopted from: National Institute for Health and Care Excellence (NICE). (2021). Caesarean birth. (NICE guideline, NG192). Published 31 March 2021. Last updated 10 June 2025.
Disclaimer
This guideline must only be used by licensed personnel who have the proper experience in the field of the guideline and should never be relied upon as a substitute for proper assessment and management with respect to the particular circumstances of each case and the needs of each patient. The applicability of guideline content and suitability to a particular case is the responsibility of the user not the guideline producers.
