Cesarean advocates claim that cesareans improve perinatal outcomes and prevent pelvic floor dysfunction. Is this true? To a degree, yes, but the benefits are minimal, and the studies supporting those benefits have caveats that reduce their validity and clinical significance, namely, outcomes with planned vaginal birth largely depend on modifiable factors such as use of oxytocin, instrumental vaginal delivery, conventional second-stage management, and episiotomy, but cesarean morbidity is mostly intrinsic to having surgery. Furthermore, almost all mothers and babies recover completely from traumatic injury or hypoxic insult, and risk-free alternatives such as pelvic floor exercises or losing weight can improve or relieve pelvic floor dysfunction. Nor does it make sense to plan cesarean surgery to avoid being among the few women who might want repair surgery later.

Passage from Chapter 5: The Case Against Liberal Use of Cesarean Surgery
image credit: Danielle Elwood, DanielleElwood.com

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