In this episode of The Baby Tribe, Afif and Anne take on one of the most emotionally charged topics in maternity care: caesarean birth. Online birth content often presents two true statements side by side: caesareans carry more risk than vaginal birth, and caesarean rates are rising. The implied conclusion is often that unnecessary caesareans are harming women. But is that a fair interpretation of the evidence? Afif and Anne unpack why context matters, especially the concept of confounding by indication: the idea that the reason someone receives an intervention is often linked to the outcome being measured. Using a NICU analogy, they explain why comparing caesarean outcomes with uncomplicated vaginal births can be deeply misleading. They also discuss planned versus emergency caesareans, absolute versus relative risk, the risks of doing nothing, and why both hospital maternity care and private birth care can carry their own biases. The episode includes a breakdown of a 2023 systematic review and meta-analysis comparing planned caesarean delivery with planned vaginal delivery in randomized trials. This is not an episode about promoting caesareans or dismissing vaginal birth. It is about evidence, nuance, and helping women recognise the difference between informed consent and fear-based messaging. Learn more about your ad choices. Visit megaphone.fm/adchoices