Response to Natural childbirth ideology is endangering women and babies/Every CS must count (Letter)

Abstract

We thank the author for highlighting the important issue of maternal mortality related to mode of birth and in particular the increased risk of mortality associated with caesarean section (CS). We agree that the balance of evidence is that there is a measurably higher risk of mortality associated with CS, but we chose not to focus on this for several reasons. First, it is an extremely rare adverse outcome. Second, it is the individual's own risk that is most important in counselling and gaining informed consent. The population‐based data are informative but not especially useful for a woman who is very low‐risk for surgical or anaesthetic complications, but has a strong obstetric indication for CS. However, we entirely agree that when significant numbers of women are choosing CS for no obstetric indication these increased risks of mortality must be discussed and included in the consent process.