The evidence shows that a Caesarean section is more than just another birth option. Maternal death rates for those who have Caesareans are between three and nine times higher than for those who deliver vaginally. Maternal sickness rates following Caesareans are between five and 10 times higher than those associated with normal childbirth.
The main risks to the baby are premature birth and respiratory problems. The incidence of respiratory illness in planned Caesarean babies - whose mothers have not been in labour - is seven times higher than in babies born vaginally; the changes in the baby's lungs in response to the mother's contractions simply do not occur.
A 1995 Cambridge survey of more than 33,000 births shows a threefold increase in respiratory illness in babies whose mothers had "elective" Caesareans - those scheduled to take place before the onset of labour - compared with infants whose mothers had unplanned or "emergency" Caesareans during labour. These babies were more than twice as likely to have breathing problems.
Caesareans, research shows, are bad for women's health. With the advent of superbugs, infection poses greater risks. Urine, chest, breast, wound and womb infections have all been reported following Caesareans. Infection rates vary acccording to the study quoted.
One 10-year study of more than 2, 500 Caesarean mothers showed that the rate of complications during surgery was 15 per cent. Haemorrhaging and womb lacerations were the most common complications. One woman in three was sick following the operation, with 25 per cent developing a fever. Four per cent of women lost between a litre and a litre and a half of blood.
It used to be thought that Caesareans preserved the pelvic floor, guaranteeing the muscle tone of the vagina, as well as that of the bowel and bladder. Pelvic-floor dysfunction is now known to be associated with Caesarean sections. One study found that 5 per cent of women suffered from urinary incontinence after the operation.
Until recently, doctors believed that Caesareans prevented the anal-sphincter damage associated with forceps or vacuum delivery. A study at the National Maternity Hospital, in Dublin, found anal-sphincter damage in women who had had Caesareans late in labour, but none suffered from subsequent incontinence.
Caesareans are a marker for future complications. A massive Swiss study of childbirth following Caesareans concluded that "a history of Caesarean delivery significantly elevates the risks for mother and child in future deliveries".
The research found significantly more maternal fever, clotting, bleeding in pregnancy due to placenta praevia - a potentially serious complication, involving the separation of the placenta from the wall of the womb - and uterine rupture in mothers giving birth after Caesareans. There was also a higher incidence of perinatal mortality and of Caesarean hysterectomy.
Two years ago, in a Dublin hospital, an otherwise healthy mother died at the age of 30, following an elective repeat Caesarean section for placenta praevia, having had surgery previously for "failure to progress" in labour.
Despite having a Cesarean hysterectomy to control bleeding, she died following a heart attack. The placenta was found to be strongly adherent to the womb, a Caesarean complication known as "placenta accreta".