(160) Planned C-section or attempted vaginal delivery: which is the more environmentally friendly?

To compare the environmental impact of attempted vaginal birth and planned cesarean section and to identify key levers to improve our impact.

Study Design:
This single-center study (Lille, France) used Life Cycle Assessment (LCA) methodology to evaluate the environmental impact of childbirth from labor admission to discharge. Two delivery scenarios—attempted vaginal delivery and planned c-section—were compared, including associated complications and anesthesia. Environmental impacts covering 80% of total effects were analyzed.

Results:
Depending on the environmental indicator assessed, attempted vaginal delivery results in an impact between 4% and 84% lower than planned c-section—even when accounting for potential complications, various modes of analgesia, and all possible delivery outcomes. For exemple, it reduces the impact by 46% in terms of climate change, 44% of fossil ressources use, 30% of mineral and metal ressource use, and 26% of water consumption. In our center in France, the estimated carbon footprint of attempted vaginal delivery is 23.2 kg CO₂e, compared to 42.9 kg CO₂e for planned c-section.

Conclusion:
Choosing vaginal delivery over scheduled c-section, when clinically appropriate, could reduce environnemental impact. Beyond mode of delivery, healthcare professionals can reduce environmental impact by addressing other modifiable aspects of obstetric care, without compromising safety or quality. These include reducing the use of medical devices and consumables, as well as acting directly on the devices themselves—particularly through improvements in raw material sourcing and local manufacturing.