Cesarean Birth — Evidence Library

What it is

Surgical birth through incisions in the abdomen and uterus, either planned in advance or decided during labor.

Evidence review links

Each link opens the full review on the publisher's site in a new tab.

Possible benefits

Can be lifesaving in specific medical situationsReview sources ↓
Planned cesareans allow logistical preparationReview sources ↓

Possible risks

Major abdominal surgery — longer recovery than uncomplicated vaginal birthReview sources ↓
Risks of bleeding, infection, blood clots, and impact on future pregnanciesReview sources ↓

Alternatives

Vaginal birth (spontaneous or induced) when medically appropriateReview sources ↓
Trial of labor after cesarean (TOLAC) for eligible candidatesReview sources ↓

Current evidence

ACOG and WHO both emphasize that cesareans can be lifesaving when medically indicated, while population-level increases in cesarean rates do not automatically translate into better outcomes. For an individual family, the key is the specific indication, urgency, alternatives, and recovery plan. Use BRAIN questions to distinguish an emergency cesarean from a non-urgent recommendation where there may be time to ask about waiting, labor support, position changes, or additional assessment.

Where the evidence is clear · where people may choose differently

For most topics, guidelines from ACOG, WHO, and other major bodies broadly agree on the core safety points (when to act in an emergency, informed-consent standards, monitoring baselines). Where reasonable people — and even guidelines — differ tends to be around thresholds (when to start or stop something), preferences (comfort, environment, support), and values (how you weigh small risks against benefits). Use the questions below to explore those pieces with your care team.

Educational only. Your care team can help you weigh what applies to your specific situation.