March 2018 - Tees Law

Types and causes of common birth injuries in babies

Posted on 16 March 201810 July 2025 by Sarah O'Sullivan

Birth injuries in babies are devastating and can have lifelong effects. Parents often seek answers and support when faced with such circumstances. This guide explores the causes of common birth injuries and provides insights into medical negligence claims.

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Our experienced clinical negligence lawyers are here to guide you through the claims process, from your initial consultation to financial settlement. Contact us for a free, no-obligation conversation.

Understanding birth injuries

A birth injury occurs when a baby is harmed before, during, or just after delivery. While some injuries are unavoidable, others result from medical negligence. Examples include:

Brain injuries: Caused by oxygen deprivation (anoxia or hypoxia) or physical trauma.
Shoulder dystocia complications: Leading to nerve damage like Erb’s palsy.
Obstetric brachial plexus Injury: Resulting in loss of arm movement and sensation.
Broken bones: Often due to improper use of instruments.
Stillbirth and beonatal death: Tragically, some birth injuries result in the loss of a baby.

Causes of birth injuries Due to medical negligence

Medical negligence may include:

Failure to monitor the baby’s heart rate
Mismanagement of complications during labour
Delays in seeking specialist help
Incorrect use of delivery instruments

If you suspect negligence, we are here to listen and advise you.

Types of birth injuries

Brain injury at birth

Brain injuries are among the most severe birth injuries. Symptoms may include developmental delays, mobility issues, and cognitive impairment. Cerebral palsy is a common outcome of severe brain injury.

Causes:

Anoxia (complete oxygen deprivation)
Hypoxia (reduced oxygen supply)
Physical trauma during delivery
Maternal infections or untreated health conditions

Shoulder dystocia complications

Shoulder dystocia occurs when a baby’s shoulder gets stuck during delivery. It can lead to nerve damage, fractures, or hypoxia. Prompt medical intervention is critical.

Obstetric brachial plexus injury

This injury damages the nerves in the shoulder, leading to paralysis or weakness. Erb’s palsy is the most common form, often caused by shoulder dystocia.

Broken bones during delivery

Fractures may occur due to improper instrument use or excessive force during delivery. Babies with underlying bone conditions are at greater risk.

Stillbirth and neonatal death

In severe cases, birth injuries can lead to stillbirth or neonatal death. Possible causes include:

Placental abruption
Umbilical cord prolapse
Severe hypoxia
Birth trauma

How we can help

At Tees, we are committed to helping parents uncover the truth about their baby’s birth injury. While no financial settlement can undo the trauma, it can provide essential support for your child’s care and future.

Contact us

If you have concerns about your baby’s birth injury, call us for free advice. Our dedicated legal team will support you every step of the way.

Disclaimer: This content is for informational purposes only and is not a substitute for medical or legal advice. Please consult your doctor or legal adviser for further guidance.

Medical negligence leading to uterine rupture

Posted on 15 March 201810 July 2025 by Sarah O'Sullivan

Understanding the possible risks, symptoms and causes of uterine rupture can help mothers make informed decisions about their care.

How to claim compensation for uterine rupture

If you have experienced a uterine rupture that was not detected or adequately managed by your assigned healthcare providers, our skilled solicitors at Tees are available to assist you in seeking compensation. We’ll listen to your experience, and help you find out what happened during your care – you may be eligible for compensation.

Uterine rupture

Uterine ruptures are very rare, but they can have devastating consequences for parents and their children. Complications during pregnancy can lead to health problems for mother and baby. In extreme cases, they may even lead to the death of the mother and/or baby or both. Other complications as a result of a uterine rupture can have lifelong consequences, including brain damage and learning disabilities. The mother might be advised not to attempt to have children again, which can be deeply upsetting if she had planned a larger family.

Mothers who attempt a vaginal birth after caesarian (VBAC) but receive substandard care which causes a medical problem, may have a medical negligence claim. For example, if their care provider did not identify a suspected uterine rupture, or carry out an emergency caesarean section in a timely manner, there may be a claim for negligence.

What is uterine rupture?

Uterine rupture is a serious medical condition where the wall of the uterus (the womb) tears during pregnancy.

Uterine ruptures are very rare. They happen in approximately 2 out of every 10,000 pregnancies in the UK , so the chances of it happening are low.

However, when a uterine rupture occurs, it is very important that mother and baby receive the correct emergency medical care. The condition has potentially life-threatening consequences for mother and baby, including maternal haemorrhage (bleeding), severe brain injury and stillbirth.

What causes uterine rupture?

Uterine rupture is a risk during any pregnancy. However, some risk factors are linked to an increased chance of it happening.

Uterine rupture following a previous caesarean section

A rupture is more likely if there is scar tissue in the uterus. Scarring in the uterus can be caused by a caesarean section and some types of abdominal surgery. Most uterine ruptures occur in women who have had a previous caesarean section. The physical stress of pregnancy, the baby’s growth and contractions may cause the scar to rupture. This is because scar tissue is not as elastic as normal tissue and thus does not stretch as well as normal tissue and is much more likely to tear when stretched.

A delivery plan should be created and discussed where a woman has had a previous caesarean section (or has any other known factors that increase the risk of a uterine rupture). This should form part of the mother’s care during pregnancy. The plan should include the mode for baby’s delivery. A consultant will be involved and will discuss the plan with the mother at some point during her pregnancy, and the plan is reviewed as she gets closer to her due date. The woman should be given all the information so that she can make an informed choice.

Mothers who have had a previous caesarean section can still attempt a vaginal birth if they so wish. However, an emergency caesarean might be necessary if there are complications during labour. Mothers attempting a vaginal birth after caesarean (VBAC) should be closely monitored during labour. If there are any signs of uterine rupture, labour is usually abandoned and an emergency caesarean section carried out. Mothers with a previous uterine rupture or classical caesarean scar are at particular risk of suffering a uterine rupture. Her doctor or midwife should recommend an elective caesarean section and advise against attempting a vaginal delivery. This is because of the increased risk of suffering a uterine rupture.

Other potential causes of a uterine rupture

Uterine ruptures are very rare in a mother with an unscarred uterus, but this may happen for example where drugs used to induce labour overstimulate the uterus.

Traumatic injury to the uterus can also cause uterine rupture. Common causes of traumatic injury include car accidents, assault or difficult assisted delivery (such as a forceps delivery). If a rupture is caused by negligent actions of a doctor or midwife, the mother might have a medical negligence claim.

Other uterine rupture risk factors include:

if you have had five or more children
your baby is too big for your pelvis
if you have excess of amniotic fluid
in multiple births e.g. twins, triplets, quadruplets etc.

Risk of repeat uterine rupture

If you have had a uterine rupture before, you are particularly at risk of suffering another rupture if you become pregnant again. In this situation, your doctor will recommend a caesarean section, without attempting spontaneous (natural) labour and delivery. Your doctor or midwife should explain this to you during your pregnancy, as well as the relative risks and benefits to you and your baby.

Signs and symptoms of uterine rupture

Many of the symptoms of uterine rupture are ‘nonspecific’. Some of the symptoms of a uterine rupture could be associated with other medical conditions and it is important that care providers make a firm differential diagnosis.

In particular, midwives and doctors caring for mothers attempting VBAC are trained to recognise signs of uterine rupture and the steps to be taken. VBAC women are categorised as high risk and are continuously monitored once in labour.

Possible symptoms of uterine rupture include:

vaginal bleeding
a bulge underneath the pubic bone
significant pain in the lower abdomen
abdominal pain or soreness
painful from the scar area
pain between contractions
difficulty or failure to locate the baby’s heartbeat
drop in the baby’s heart rate
drop in the mother’s blood pressure
loss of uterine contractions, or if the labour fails to progress naturally.

This list is not exhaustive, and not every woman will experience all of the above symptoms. Seek medical attention immediately if you are concerned about your or your baby’s health during pregnancy. Your care providers should listen to you if you’re worried, and take you seriously. If you think your doctor or midwife did not listen during your pregnancy, you can contact your local Patient Advice and Liaison Service (PALS) for advice and support.

Early signs of uterine rupture during labour

Uterine ruptures can occur during labour, typically during the early stages of labour. One of the first signs of uterine rupture may be an abnormality in the baby’s heart rate. A change in the baby’s heart rate might indicate that the baby is in distress and needs urgent delivery. Your midwife or doctor should note the signs of foetal distress and take immediate action to deliver the baby.

Possible symptoms of uterine rupture on the mother’s side include an increased heart rate, drop in blood pressure or signs of maternal haemorrhage and pain uncharacteristic of contractions.

Risk of uterine rupture after a previous Caesarean section

If you have had two or more caesarean sections before, a senior obstetrician should advise you and agree a plan for delivery.

If you are considering a VBAC, your doctor should tell you about the risks and benefits of a planned VBAC compared to an elective repeat caesarean section (ERCS). Their recommendation should depend on your individual circumstances. In general, your doctor should make sure you understand the risks and guide you towards a feasible plan. General topics your doctor should cover include: risk of uterine rupture, possible risks to your own health and your baby’s health and the likelihood of a successful VBAC. Above all, your caregivers should ensure that you are comfortable with the plans for your delivery. When considering a potential VBAC or ERCS, your doctor should explain the risks, including :

a planned VBAC is linked to a 1 in 200 (0.5%) risk of suffering a uterine rupture
a planned ERCS is linked to a small increased risk of placenta praevia and/or placenta accreta in future pregnancies, and of pelvic adhesions
attempted VBAC which ends in an emergency caesarean delivery carries the greatest risk of complications for mother or baby.

Your doctor should explain that a planned VBAC should only take place in a suitably staffed and equipped delivery suite. The unit should have continuous intrapartum care and monitoring with resources available for immediate caesarean delivery and advanced neonatal resuscitation.

Caregivers should help mothers by providing information, explaining the risks and ensuring that the mother is happy with her delivery plan. Mothers should feel that their wishes are respected and that their doctors listen to them.

To help ensure your delivery experience goes as you wish, you might consider preparing questions for your consultant or midwife before your antenatal care appointments.

Uterine rupture terminology

Below is a useful glossary of terms which you might hear in connection with uterine rupture.

Where appropriate, these terms are explained specifically in the context of uterine rupture.

Placenta praevia: a condition where the placenta is positioned unusually low in the uterus, normally next to or covering the cervix
Placenta accreta: a serious medical condition where the placenta remains fully or partially attached to the wall of the uterus after the baby is born
Foetal distress: a term used to describe signs during labour which may indicate a problem with the baby’s well-being.

Disclaimer: All content is provided for general information only, and should not be treated as a substitute for the medical advice of your own doctor, any other health care professional or for the legal advice of your own lawyer. Tees is not responsible or liable for any diagnosis made by a user based on the content of this site. Tees is not liable for the contents of any external internet sites listed, nor does it endorse any service mentioned or advised on any of the sites. Always consult your own GP if you’re in any way concerned about your health and your lawyer for legal advice.

Forceps delivery complications and possible negligence claims

Posted on 15 March 20189 July 2025 by Sarah O'Sullivan

Forceps are sometimes used to deliver a baby, usually if the mother becomes exhausted, the baby is distressed or is in an awkward position. Forceps are meant to expedite delivery, with minimal risk of trauma to mother and baby.

Tees Law provides expert legal advice for medical negligence claims. Please note: we can only work with people where the birth took place in England or Wales, UK.

Problems after forceps delivery

Forceps should only be used when medically necessary, and with the mother’s consent. Unfortunately, some forceps deliveries can cause serious and devastating injuries to mothers and their babies. It can be especially traumatic for mothers who did not plan a forceps delivery (even if no physical harm was caused to mother or baby).

Forceps delivery medical negligence claims

If you experienced a problem during or after a forceps delivery, you could have a claim for negligence if there was:

any significant injury to the baby
any physical or psychological injury to the mother
lack of adequate consent for the procedure

Risks of forceps delivery

Forceps deliveries can cause superficial, temporary birth injuries to the baby. The NHS states that risks of forceps deliveries include:

temporary marks on baby’s face
small cuts or bruises on baby’s face
a bruise on baby’s head (known as ‘cephalohaematoma’) which may increase the baby’s risk of developing jaundice.

The NHS advises that small injuries generally heal a few days after birth. In normal circumstances forceps shouldn’t have a long-term effects on the baby.

However, forceps deliveries can be distressing for parents and babies. It’s very natural for parents to be concerned if the baby has suffered scratches or bruises during delivery. The mother should be warned about the likely injuries from forceps before the baby is delivered or, if it’s an emergency delivery, shortly after.

Risk of serious birth injury due to forceps delivery

Serious birth injuries due to forceps deliveries are very rare. However, forceps can lead to long-term or permanent health issues for the mother and baby. The risk of complications during a forceps delivery may increase if the baby is very large, in a difficult position, the head is positioned relatively high up in the birth canal or the doctor has had no training or has no experience in their use.

Possible injuries as a result of a forceps delivery include:

bleeding (haemorrhage) inside baby’s skull, and/or skull fractures
damage to the baby’s facial nerves
swelling on baby’s head
trauma to the baby’s eyes
brain injury to the baby, such as cerebral palsy
physical injury to the mother (usually 3rd or 4th degree tears).

The risk of a serious birth injury during a forceps delivery is incredibly low, but it can happen. In very rare cases, the baby may suffer a permanent birth injury or die shortly after birth as a result of their injuries.

When and why are forceps used?

Forceps are a form of assisted delivery. Assisted deliveries are quite common in the UK (about 1 in every 8 births) and they’re most common when labour is particularly long, the baby is distressed and spontaneous delivery is likely to be slower.

Doctors might recommend a forceps delivery if:

the baby is showing signs of distress, such as a decreased or increased heart rate
the baby is in a difficult position to be delivered by the mother’s effort alone
the mother needs help delivering the baby, for example if she has been in labour a long time and has become too exhausted.

Doctors may recommend forceps if the baby needs to be born quickly – for example, if there is an immediate risk to the mother or baby’s life.

The use of forceps depends entirely on the individual case, and the wishes of the mother. Doctors may recommend forceps if the mother has planned a vaginal birth and needs assistance during the second stage of labour. The second stage of labour begins when the mother’s cervix is fully dilated. By the second stage of labour, the baby is normally at or below the mid-cavity of the mother’s pelvis. If the baby is sufficiently low down in the birth canal, forceps delivery may be less risky than an emergency caesarean section.

If the baby is very low down in the birth canal, an emergency caesarean section may not be the best mode of delivery as the baby would need to be pushed back up the birth canal in order to be delivered by caesarean section. Therefore, in some situations, forceps may be the safest mode of delivery. There is some risk to the mother/baby, but as all options carry some risk, the doctor will recommend the safest mode of delivery taking all the circumstances into account. Further, if the baby has progressed far down the birth canal enough for forceps to be a safe option, then they should advise you accordingly and seek your consent.

Doctors may recommend forceps to help minimise the risk of injury and help your baby to be born safely, in the right conditions. Forceps can help mothers who wish to have a vaginal birth avoid a caesarean section. Forceps are typically recommended if a caesarean section is considered too risky or if the baby will be delivered quicker than by caesarean section.

Different types of forceps and how they work

There are many different types of forceps, each designed for use in specific situations. Common types of forceps you might hear about include:

Outlet forceps (e.g. Wrigley’s forceps)

Wrigley’s forceps are smaller and gentler than other types of forceps. They are designed for use when the baby is very far down the birth canal, and is almost born. They’re typically used when baby’s head is already showing. You might also hear them referred to as ‘lift-out’ forceps.

Low/mid-cavity forceps (e.g. Neville Barnes forceps)

Mid-cavity forceps are slightly bigger than outlet forceps and are normally used when the baby is positioned a bit further up the birth canal.

Rotational forceps (e.g. Kielland’s forceps)

Kielland’s forceps are used where the baby’s head needs to be rotated into a position suitable for a safe vaginal delivery before delivery takes place. In the wrong hands, Kielland’s forceps are potentially dangerous medical instruments and can cause serious trauma to the mother and baby.

The Royal College of Obstetricians and Gynaecologists (RCOG) recommends that Kielland’s forceps be only used in theatre, with tested and effective local anaesthetic. They should only be used by doctors trained and experienced in their use. When used correctly, Kielland’s forceps can help to achieve a successful vaginal birth.

Consent to use of forceps

In some situations, a forceps delivery may be the safest option for mother and baby. Advice from the RCOG suggests that a caesarean section may not always be an alternative to an assisted delivery because of the risks involved. Second stage caesareans are very difficult procedures, which can lead to complications for mother and baby. They may also have an effect on future pregnancies. A caesarean section may not always be a viable alternative to a forceps delivery, and your caregivers should tell you about all the options available so that you can make an informed choice.

Doctors and midwives must obtain consent to a forceps delivery. The consent should be:

voluntary: the decision to consent to treatment should be entirely the patient’s own. So, you shouldn’t be pressured into a certain type of treatment by friends, family or medical staff.
informed: caregivers should tell you about the treatment and answer your questions. They should tell you about the risks, benefits and alternative treatments available. In the case of forceps, your doctor should also tell you about other procedures such as ventouse (vacuum extraction) and caesarean and the benefits and risks to you and your baby.
given with capacity: in order to consent to treatment, you must be able to understand the information your caregivers present you with. If a patient lacks capacity, caregivers are allowed to treat you without your consent if it’s in your best interests to do so.

Can I refuse to give consent for the use of forceps?

You have a choice about whether forceps are used to deliver your baby or not. Mothers may refuse to consent to any procedure they don’t want during their labour and delivery.

Before your doctor attempts a forceps delivery, they must fully explain the procedure to be carried out, its likely complications and the alternatives available. The doctor must also explain what will happen if the forceps delivery is unsuccessful (for example, an emergency caesarean section). The doctor must answer all your questions and address any concerns you may raise. However, it must be borne in mind that forceps deliveries usually take place as an emergency, in situations where you may be quite distressed and the doctor may need to deliver your baby quickly if the baby is in distress. Your birth partner may ask questions on your behalf.

If you wish to avoid a delivery by forceps, make sure your wishes are included on your birth plan and discuss it with the attending midwife beforehand. If you are worried, ask your doctor or midwife once you are in labour.

Consent forms aren’t normally signed for forceps deliveries. You will be asked to provide verbal consent to the procedure. However, if the doctor or midwife thinks a caesarean section may be necessary if the forceps delivery fails, you should be asked to sign a consent form.

If you had a forceps delivery, and think it might have caused a negligent injury to you or your baby, talk to our birth injury claims specialists. Please note, Tees Law is based in England, UK and we are only able to work with clients where the birth took place in England or Wales, UK.

Birth injury statistics: Birth injury claims

Posted on 15 March 201828 July 2025 by Sarah O'Sullivan

Most of the time, pregnancy and childbirth is straightforward. However, sometimes there are complications and there can be injury to the mother, the baby or both.

Sometimes these injuries are unavoidable, but every year there are a number of cases where injuries, which can have life-changing consequences, are caused by medical negligence.

If something happened to you, or your baby, you don’t have to suffer in silence – it’s natural to want to understand what happened, and why. Our specialist birth injury claims solicitor can help you find a way forward.

We’ve all the expertise you need. We’ve advised many women on wide-ranging problems related to birth injuries, including:

injuries to the baby – such as stillbirth, cerebral palsy, Erb’s palsy, hyperbilirunia, and broken bones
injuries to the mother – such as pre-eclampsia, haemorrhages, perineal tears, uterine prolapse, faecal incontinence, complications with anaesthetics, and infections
failed sterilisation
disabled children – such as a failure to detect spina bifida or hydrocephalus, or misjudging the risk of Down’s syndrome.

If you or your baby has suffered from a birth injury and you are worried about the care you received, contact us today.

Our specialist birth injury claims solicitors understand what you’re going through, and we can help you get answers about your care. We’ll listen to your experiences, and help you find out what happened during your pregnancy and delivery.

The UK is one of the safest countries in the world to have a baby in. However, there are inherent risks associated with pregnancy and childbirth. Here, we look at the potential risks and benefits of different types of delivery.

Overall, the UK is a very safe place to have a baby. There were 696,271 live births in England and Wales in 2016 and the stillbirth rate is decreasing. Data shows that in 2016 the stillbirth rate decreased to 4.4 per 1,000 births (England and Wales – the lowest rate recorded since 1992.

However, research suggests that maternity care can be improved. Research shows that 921 babies suffered a serious birth injury in 2015. Many of those injuries were life-altering or, very sadly, resulted in the baby’s death. Of these:

119 babies suffered from intrapartum stillbirth (the baby died during labour)
147 babies died during the neonatal period (the baby died shortly after birth)
655 babies suffered a severe brain injury.

Pregnancy and childbirth can also put the mother at risk. In very rare cases, the mother can die during pregnancy and childbirth (called maternal death, or maternal mortality). In 2010-12 , the maternal death rate in the UK was 10 in every 100,000 maternities. These figures also include women who opted for a termination of pregnancy or suffered an ectopic pregnancy.

Risks of birth injury during a home birth

Deciding where to have your baby is a very personal decision. It is your choice, and you don’t have to have your baby in hospital if you don’t want to. Some parents choose a home birth so that their baby is born in a relaxed, comfortable home environment. Home births might be an option if you want to avoid a medicalised labour.

Based on current research, the NHS reports that “as a whole, home births are as safe as ones in medical settings”. Serious complications occur in 4.3 out of every 1,000 births (whether in hospital, a birth centre or at home).

However, research suggests that in certain conditions a home birth may be more risky than a hospital delivery. In first pregnancies, a home birth almost doubles the risk of the baby suffering a birth injury (compared to delivery at a hospital or birth centre). A home birth can, in certain conditions, increase the risk of complications during delivery (up to a three times greater risk). This includes a broad range of complications – including very serious injuries such as brain injury to the baby, to treatable injuries including bone fractures. 45% of first time mothers who attempt a home birth are transferred to hospital, compared to 12% of women who have had a baby before.

Despite the relatively increased risks, the chances of suffering a serious complication during a home birth remain low. If you are considering a home birth, involve your midwife or GP early on. They are best placed to advise you, and they should ensure you are aware of the benefits and any potential risks of a home birth.

Risks of birth injury at a birth centre or midwifery unit

Birth centres (also called midwifery units) are different to hospitals. They’re run by midwives, and often have a more relaxed atmosphere compared to a hospital maternity unit. Some parents opt for a birth centre delivery because the unit has:

friendly, welcoming atmosphere
higher chance of being attended by a familiar midwife
lower rate of medical intervention (less likely to have a forceps or ventouse delivery).

There are no specific risks linked to birth centres, but your midwife/doctor might recommend a hospital delivery instead if your pregnancy is considered ‘high risk’. You might have a high risk pregnancy if: you have a pre-existing medical condition, if you experience complications during pregnancy or if you had a complication during a previous delivery. Normally this is a precautionary measure to reduce the risk of harm to you or your baby. If there are complications during your labour (for example, if the baby is in distress and you need an emergency caesarean section) a hospital is equipped to deal with it.

Generally speaking, having a baby at a birth centre is very safe. They are reassuring, homely environments which can help to reduce the stress and anxiety around giving birth. If you would like to have your baby in a birth centre, talk to your midwife or GP and include this in your birth plan.

Risks of birth injury during a vaginal delivery

There are risks during any type of delivery, and vaginal deliveries are no exception. If you are planning a vaginal delivery, your midwife/doctor should explain the benefits as well as the potential risks.

9 out of 10 women suffer a perineal tear during a vaginal delivery. Unfortunately, some of these tears are serious (3rd or 4th degree tears) and are considered maternal birth injuries. About 3% of women suffer a serious tear which affects the muscles in the anus (back passage) and perineum (the area between the vagina and anus). Tears can damage the pelvic floor muscles, which control your bladder and bowel movements. Consequently, vaginal deliveries are associated with an increased risk of bowel and urinary incontinence (compared to a caesarean section). The symptoms of serious tears can last a long time, and be very difficult to cope with – affecting the mother’s career, relationships and day to day life. Research suggests that, compared to a caesarean section, women who have a vaginal delivery are 67% more likely to suffer urinary incontinence. The effects are also more likely to be long term, with a 275% increased risk of urinary incontinence 10 years’ after a vaginal birth (compared to a caesarean section).

Vaginal births can also be complicated by shoulder dystocia. Shoulder dystocia is when the baby’s shoulder becomes stuck behind the mother’s pelvic bone, with the head already delivered. It is a rare complication which affects in about 1 in every 150 births. It can cause Erb’s palsy or possibly brain injury to the baby.

You can read more here about possible birth injuries to mothers, and their frequency.

Certain factors can increase the risk of injury during a vaginal birth – including your weight, age, medical history and whether you’ve had any children before. Your caregivers should tell you about the risks so that you can make an informed decision about the mode of delivery before you have your baby.

Risks of birth injury during an elective or repeat caesarean section

A quarter of babies in the UK are born through caesarean section. Most of these babies are born healthy, and the procedure is normally straightforward. However, a caesarean section is still major surgery. Any type of surgery has risks, though the chance of a serious problem are quite low. When caesarean sections go wrong, it can be extremely traumatic for babies and their parents.

If your pregnancy is considered ‘high risk’ or has been particularly difficult, your midwife/doctor might recommend a planned (or ‘elective’) caesarean. In certain situations, planned caesareans can help manage a high risk pregnancy and reduce the chance of mother or baby suffering serious harm. Your midwife/doctor should explain the potential risks and benefits of a planned caesarean, and answer any questions you might have. Planned caesarean sections are usually recommended if, on balance, it’s less risky to have a caesarean section than ‘spontaneous’ (natural) labour and a vaginal delivery. The reasons why your midwife/doctor may recommend a planned caesarean include: if you have a low-lying placenta, your baby is in the breech position or if you’ve previously had a caesarean section.

Complications following caesarean sections include:

3-4 in every 100 babies born by planned caesarean suffer from breathing problems (compared to 2-3 in every 100 babies born by vaginal delivery)
there is a chance the mother might develop a blood clot in her lung (pulmonary embolism). Pulmonary embolisms after a caesarean section are very rare, but they can be life-threatening. 1 in 1,000 women who suffer a pulmonary embolism following a caesarean section die from the condition
infections after a caesarean section are also fairly common. They normally take a few weeks to heal, but can be quite painful.

The above list is not exhaustive. There are additional risks for women who have had three or more caesarean sections, including:

placenta accreta (retained placenta following baby’s birth)
emergency hysterectomy (removal of the womb)
damage to the bowel (which affects 1 in 1,000 women), bladder or ureter which can cause incontinence
higher risk of stillbirth in future pregnancies (4 in 1,000 compared to 2 in 1,000 vaginal deliveries).

It usually takes longer to recover from a caesarean section than a vaginal birth. This is because a caesarean section is a major surgery, and your wound needs time to heal. Some mothers struggle to sit upright, or get around much just after their baby is born.

Emergency caesarean section

Your doctor might recommend an emergency caesarean section if there are complications during your labour. Situations where an emergency caesarean section might be necessary include:

if your baby is distressed (normally indicated by changes in baby’s heart rate)
your labour is particularly long or difficult, or you have a long second stage
if your baby is in an awkward position or is particularly big
the mother’s well-being is at risk
a vaginal delivery is not possible without endangering the health of the baby or mother.

13% of babies are born by emergency caesarean section. It can be a frightening, and even traumatic situation for parents. Unfortunately, some women end up not having the birth experience they’d planned due to unforeseen complications during labour which necessitate an emergency caesarean. It can be a difficult experience for both partners, and the physical and emotional recovery can be difficult.

Risks of birth injury during vaginal birth after caesarean section (VBAC)

Many women choose a vaginal birth after a caesarean section in a previous pregnancy (VBAC), for example, if they wish to avoid another caesarean.

VBAC deliveries have a 72-75% success rate (this is increased to 85-90% if you’ve had a vaginal delivery before). Many women achieve their goal of a successful vaginal delivery, and a successful VBAC may be the safest delivery option. However, VBAC deliveries are associated with the following risks:

25% of women who attempt a VBAC will be unsuccessful and require an emergency caesarean section to deliver their baby – a procedure which can be traumatic and frightening
women who attempt a VBAC have a 1% higher chance of requiring a blood transfusion or suffering a uterine infection (compared to a repeat caesarean section)
0.5% (1 in 200) women suffer uterine rupture during VBAC. This is where the scar of a previous caesarean section weakens and splits, which can be life-threatening
0.2% (approximately 2 out of every 1,000) of babies born by VBAC suffer brain damage or, sadly, die during delivery. This risk is comparable to the risks of a first-time labour. The risks of brain damage are lower during an elective repeat caesarean section (0.1% or 1 in every 1,000).

The risks increase if the mother attempts a VBAC but is unsuccessful. Your care provider should make you aware of this.

If you have previously had a caesarean section, your midwife and doctor should explain the risks and the benefits of a VBAC compared to a planned caesarean section. They should also explain the risks of multiple caesarean sections and how this could affect any subsequent pregnancies.