{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T11:11:15Z","timestamp":1789038675200,"version":"build-2803163510"},"reference-count":23,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:00:00Z","timestamp":1788998400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:00:00Z","timestamp":1788998400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>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\u2010section), and to identify opportunities for improvement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and Methods<\/jats:title>\n                    <jats:p>We performed a life cycle assessment to quantify 16 environmental impact indicators from vaginal and c\u2010section deliveries. Data were collected at Lille University Hospital in 2024. Hotspot analyses were undertaken to identify the most impactful stages within each scenario.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Attempted vaginal delivery consistently had a lower environmental impact compared with planned c\u2010section, the carbon footprints of which were 23.2\u2009kg carbon dioxide equivalent (CO\n                      <jats:sub>2<\/jats:sub>\n                      e) versus 42.9\u2009kg CO\n                      <jats:sub>2<\/jats:sub>\n                      e, respectively. Compared with planned c\u2010section, 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%.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Attempted vaginal delivery is more environmentally sustainable compared with planned c\u2010section. Perinatal health professionals should incorporate environmental considerations into clinical and public health decision\u2010making, and should engage in other efforts to reduce this sector's contributions to climate change.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aogs.70335","type":"journal-article","created":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T10:41:32Z","timestamp":1789036892000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Planned cesarean section or attempted vaginal delivery: Which is more environmentally friendly? An observational life cycle assessment study in France"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-4339-8270","authenticated-orcid":false,"given":"Sherazade","family":"Jaafar","sequence":"first","affiliation":[{"name":"Department of Obstetrics CHU Lille  Lille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-1098-1638","authenticated-orcid":false,"given":"Sayed","family":"Gillani","sequence":"additional","affiliation":[{"name":"Primum Non Nocere  B\u00e9ziers France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-4844-7397","authenticated-orcid":false,"given":"Sophie","family":"Cordier","sequence":"additional","affiliation":[{"name":"Primum Non Nocere  B\u00e9ziers France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2105-9784","authenticated-orcid":false,"given":"Charles","family":"Garabedian","sequence":"additional","affiliation":[{"name":"Department of Obstetrics CHU Lille  Lille France"},{"name":"Univ. Lille, ULR 2694\u2010Metrics  France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,10]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.g5178"},{"key":"e_1_2_14_3_1","unstructured":"Climate change and human health: impact and adaptation[Internet]. [cited 2025 Oct 5].https:\/\/www.who.int\/publications\/i\/item\/who\u2010sde\u2010oeh\u201000.4"},{"key":"e_1_2_14_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)60935-1"},{"key":"e_1_2_14_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.8243"},{"key":"e_1_2_14_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(23)01859-7"},{"key":"e_1_2_14_7_1","volume-title":"D\u00e9carboner la sant\u00e9 pour soigner durablement [Internet]","year":"2025"},{"key":"e_1_2_14_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)31928-7"},{"key":"e_1_2_14_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.18049"},{"key":"e_1_2_14_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.scitotenv.2012.03.006"},{"key":"e_1_2_14_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.17771"},{"key":"e_1_2_14_12_1","volume-title":"Commission Recommendation (EU) on the Use of the Environmental Footprint Methods to Measure and Communicate the Life Cycle Environmental Performance of Products and Organisations [Internet]","author":"Commission of the European Union","year":"2021"},{"key":"e_1_2_14_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.15678"},{"key":"e_1_2_14_14_1","unstructured":"Primum Non Nocere [Internet]. [cited 2025 Oct 4]. Primum Non Nocere\u2014Coaching RSE D\u00e9veloppement durable et sant\u00e9.https:\/\/www.agenceprimum.fr\/"},{"key":"e_1_2_14_15_1","unstructured":"Database [Internet]. ecoinvent. [cited 2025 Oct 4].https:\/\/ecoinvent.org\/database\/"},{"key":"e_1_2_14_16_1","unstructured":"NHS England Digital.NHS Maternity Statistics England \u2010 2021\u201322[Internet]. Accessed July 14 2025.https:\/\/digital.nhs.uk\/data\u2010and\u2010information\/publications\/statistical\/nhs\u2010maternity\u2010statistics\/2021\u201022"},{"key":"e_1_2_14_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000004449"},{"key":"e_1_2_14_18_1","first-page":"20","article-title":"\u00c9co\u2010conception des nouveaux parcours de soins","volume":"26","author":"Bonnet L","year":"2022","journal-title":"Prat En Anesth Reanim"},{"key":"e_1_2_14_19_1","doi-asserted-by":"publisher","DOI":"10.3390\/su142113957"},{"key":"e_1_2_14_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/hpm.3493"},{"key":"e_1_2_14_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2023.04.025"},{"key":"e_1_2_14_22_1","unstructured":"The Shift Project.D\u00e9carbonons les industries de sant\u00e9: rapport final sur les m\u00e9dicaments et dispositifs m\u00e9dicaux[Internet]. 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