Planned cesarean section or attempted vaginal delivery: Which is more environmentally friendly? An observational life cycle assessment study in France.

Abstract

Introduction: While the health sector is known to contribute significantly to environmental degradation, little is known about the specific ecological footprint of childbirth. We thus aimed to compare the environmental impacts of attempted vaginal delivery and planned cesarean section (c-section), and to identify opportunities for improvement.

Material and methods: We performed a life cycle assessment to quantify 16 environmental impact indicators from vaginal and c-section deliveries. Data were collected at Lille University Hospital in 2024. Hotspot analyses were undertaken to identify the most impactful stages within each scenario.

Results: Attempted vaginal delivery consistently had a lower environmental impact compared with planned c-section, the carbon footprints of which were 23.2 kg carbon dioxide equivalent (CO₂e) versus 42.9 kg CO₂e, respectively. Compared with planned c-section, attempted vaginal delivery reduced greenhouse gas emissions by 46%, water consumption by 26%, fossil resource use by 44%, and mineral and metal resource use by 30%.

Conclusions: Attempted vaginal delivery is more environmentally sustainable compared with planned c-section. Perinatal health professionals should incorporate environmental considerations into clinical and public health decision-making, and should engage in other efforts to reduce this sector's contributions to climate change.