Key messages
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Caesarean section (CS) is a life-saving intervention for specific complications during pregnancy and childbirth that should be available to all women in need. CS also confers an increased risk of maternal mortality and severe acute morbidity and a higher risk for adverse outcomes in subsequent pregnancy compared with vaginal birth. Multiple CSs are associated with a higher risk of maternal morbidity and mortality.
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Some benefits of CS, such as less frequent incontinence and urogenital prolapse have been described.
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Infants born by CS have different hormonal, physical, bacterial, and medical exposures (such as intrapartum antibiotics and uterotonins) and are exposed to more short-term risks, which range from altered immune development, allergy, atopy, asthma, and reduced diversity of the intestinal gut microbiome, compared with those born vaginally.
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Emerging research has shown biological mechanisms that underlie the acute and chronic effects of CS on child health and the long-term effects of CS on children, including how these effects might be mitigated.