Though some obstetricians tout the safety of cesareans and their value in preventing perineal damage, a systematic review of current research shows that vaginal birth is safer for mother and baby than a cesarean—unless there’s a clear, compelling health reason for having a cesarean.
The risk of perineal damage in vaginal birth is extremely small if forceps, vacuum extractor, and episiotomy aren’t used.
Cesarean surgery increases your short-term risk of blood clots, stroke, surgical injury, infection, pain, separation from your baby, psychological trauma, longer hospital stay, emergency hysterectomy, and death in the short term. In the long term, it increases your risk of pelvic pain, bowel obstruction, infertility, and future pregnancy problems like ectopic pregnancy (pregnancy outside the uterus), placenta previa (placenta over the cervix), and uterine rupture.
A cesarean raises your baby’s risk of surgical injury, respiratory problems, and breastfeeding difficulties. It increases you future babies’ risk of stillbirth, low birth weight, preterm birth, and central nervous system injury.
If you’ve had a previous cesarean, there’s a small chance your uterine scar could separate during labor and a small chance that the separation could endanger you or your baby. This is more likely if your labor is induced or if your scar is high and vertical.