 This study investigates the relationship between cesarean section without medical indication and severe maternal outcomes. The study used a multi-country, facility-based survey to obtain data from 24 countries and 373 health facilities worldwide. A total of 286,565 deliveries were analyzed, with a cesarean section rate of 25.7%. The study found that all other modes of delivery, including antipartum and intrapartum cesarean sections without medical indications, were associated with an increased risk of death, admission to ICU, blood transfusion, and hysterectomy. The association was stronger in Africa compared to Asia and Latin America. The study concludes that cesarean sections should be performed when a clear benefit is anticipated, as the higher costs and additional risks associated with this operation may not justify the potential benefits. This article was authored by Karoli G, Leapiboon M, Lumbiganan P, and others. We are article.tv, links in the description below.