The Carbon Footprint of a Cesarean Section: A Study on Real-Time, Prospectively Collected Data of Disposables, Energy, and Reusables

Aim

The healthcare sector, particularly operating rooms, is a major source of greenhouse gas emissions. To reduce this impact, it is important to assess the carbon footprint of medical procedures. The aim of this study was to assess the carbon footprint of a cesarean section, focusing on CO2-equivalent (CO2eq) emissions from disposable products, reusable products, and HVAC energy use.

Methods

A prospective observational study was conducted in a Dutch academic hospital (Feb–Jun 2025). For 50 C-sections, data on type, material, and weight of disposable and reusable products were collected. CO2eq emissions were estimated using predefined product groups linked to life cycle assessment (LCA) data. HVAC energy use was calculated from procedure time and corresponding LCA data.

Results

The mean CO2eq emission of a C-section was 33.5 [SD 2.2] kg CO2eq. Disposable products accounted for the largest share, with a mean contribution of 27.7 [SD 1.5] kg CO2eq. Among disposable the surgical drapes, sterile gauze pads, and surgical gowns were the highest emitting categories. Energy use during the procedure contributed an average of 3.4 [SD 0.9] kg CO2eq, while reusable products accounted for 2.4 [SD 0.1] kg CO2eq. The mean CO2eq emissions of planned and unplanned (urgency Levels S2 and S3) C-sections were comparable.

Conclusion

The CO2 emissions of a C-section are substantial; disposable products were the highest contributors. Emission reduction could be achieved by minimizing unnecessary utilization of disposables, replacing disposables with reusable items, or by reducing the number of C-sections performed.