Martínez-Perez O, Vouga M, Melguizo SC, et al. - Per data gained from China, 8% of pregnant women with coronavirus disease 2019 (COVID-19) experienced severe complications. Researchers here examined if mode of delivery is linked with maternal complications or neonatal transmission. From 96 level 2 or level 3 maternity hospitals throughout Spain, they included 82 pregnant patients with a positive reverse transcriptase–polymerase chain reaction (RT-PCR) test result for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Of these women, 4 presented with severe COVID-19 symptoms, including 1 with concomitant preeclampsia; all 4 underwent cesarean delivery and required ICU admission. No or mild COVID-19 symptoms were evident in rest of the 78 patients, including 11 patients requiring oxygen supplementation. Vaginal delivery was performed in 41 (53%) cases and cesarean delivery in 37 (47%) cases, for obstetrical indications in 29 and for COVID-19 symptoms without other obstetrical indications in 8. Excellent outcomes were reported in all patients with a vaginal birth. In contrast, severe maternal outcomes were reported in 13.5% and clinical deterioration in 21.6% among women undergoing cesarean delivery. Higher risk of adverse outcomes was seen among women undergoing cesarean delivery, but after adjusting for confounding factors, cesarean birth remained independently linked with an elevated risk of clinical deterioration. Surgery related physiological stress is identified to raise postpartum maternal complications. In addition, an increased risk of neonatal ICU admission was observed in correlation with cesarean delivery.