Maternal and perinatal mortality and complications associated with caesarean section in low-income and middle-income countries: a systematic review and meta-analysis

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Universal and timely access to a caesarean section is a key requirement for safe childbirth. This review identified the burden of maternal and perinatal mortality and morbidity, and the risk factors following caesarean sections in low-income and middle-income countries (LMICs). The review included 196 studies from 67 LMICs. The risk of maternal death in women who had a caesarean section was 7·6 per 1000 procedures; the highest burden was in sub-Saharan Africa (10·9 per 1000). A quarter of all women who died in LMICs had undergone a caesarean section. Maternal deaths and perinatal deaths following caesarean sections are disproportionately high in LMICs. The timing and urgency of caesarean section pose major risks.

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