Although Caesarean section is considered a relatively safe procedure, it is still surgery and therefore has risks. There is less risk for the baby than there is for the mother as this procedure is often performed for the benefit of the unborn child.

The risks associated with a Caesarean delivery include those from anesthesia, those related to surgery and those that are specific to this procedure. Caesarean births are more painful, more expensive and have a longer recuperation period than vaginal births. Some of the most common potential risks associated with a Caesarean delivery include:

For the mother:

• Reactions to the anesthesia
• Difficulty breathing from the medications
• Increased bleeding
• Blood clots in the legs, pelvic organs and sometimes the lungs
• Infection at the wound site
• Bladder, vaginal or uterine infection
• Placenta previa, placenta accreta and placenta abruptio (in later pregnancies)
• Injury to the urinary tract or bowel

For the baby:

• Injury or trauma to the baby due to the use of surgical or obstetrical devices to remove the baby from the womb (rare)
  
  
• Premature delivery or low birth weight (if the due date is not calculated accurately)
  
  
• Transient respiratory problems due to lung fluid not being reabsorbed by the fetus unless the baby passes through the birth canal

Newborns who are delivered via planned C-section also may be more likely to be transferred to a neonatal intensive care unit (NICU) and to experience lung disorders compared with those infants who are delivered via planned natural (vaginal) childbirth, according to a new study. More research is needed to establish this link.

In addition to the risks during the procedure, there are sometimes difficulties with the mother having a vaginal birth after a C-section. According to the National Institutes of Health (NIH), about two-thirds of women who attempt a vaginal birth after Caesarean (VBAC) are successful. When a woman chooses to have VBAC, it is recommended that the birth take place in a hospital and not a birthing center to ensure adequate care in case of complications.

Reports from the Centers for Disease Control and Prevention (CDC) indicate that VBACs have declined by 67 percent between 1996 and 2004 in the United States. According to the CDC, the total number of VBACs now account for slightly more than 9 percent of all deliveries. Those who do elect to have a VBAC should be aware of a slight risk of uterine rupture, which can be dangerous to both the mother and baby. This risk is reduced if the type of incision made in the uterus during the initial C-section was placed horizontally across the lowest part of the uterus (low transverse incision). Many hospitals now have stricter protocols that set the guidelines for allowing VBACs to labor normally because of the increased potential risks and liability.

In addition to these risks, C-sections also require additional recuperation time compared to a vaginal delivery. The average hospital stay following a C-section is three to five days. This is much longer than that of a natural (vaginal) birth. There is also a considerable amount of pain from this surgery, but it usually can be controlled with oral medications.

For women who have had two or more Caesarean deliveries, it is possible for a significant amount of scar tissue to develop in and around the uterus. Scar tissue development increases the risk of the mother developing chronic pelvic pain. In addition, it makes each successive C-section increasingly more complicated. For example, the risk of placenta previa (where the placenta covers the cervix), placenta accreta (the placenta grows too deeply into the uterus and adheres too tightly) and placenta abruptio increases with the number of Caesareans a woman has.