C-section

 

Alternative Names

Abdominal delivery; Abdominal birth; Cesarean birth

Definition

A C-section is the delivery of a baby through a surgical opening in the mother's lower belly area. It is also called a cesarean delivery.

Why the Procedure is Performed

There are many reasons why a woman may need to have a C-section instead of a vaginal delivery. The decision will depend on your doctor, where you are having the baby, your previous deliveries, and your medical history.

Problems with the baby may include:

  • Abnormal heart rate
  • Abnormal position in the womb, such as crosswise (transverse) or feet-first (breech)
  • Developmental problems, such as hydrocephalus or spina bifida
  • Multiple pregnancy (triplets or twins)

Health problems in the mother may include:

  • Active genital herpes infection
  • Large uterine fibroids near the cervix
  • HIV infection in the mother
  • Past C-section
  • Past surgery on the uterus
  • Severe illness, such as heart disease, preeclampsia or eclampsia

Problems at the time of labor or delivery may include:

  • Baby's head is too large to pass through the birth canal
  • Labor that takes too long or stops
  • Very large baby
  • Infection or fever during labor

Problems with the placenta or umbilical cord may include:

  • Placenta covers all or part of the opening to the birth canal (placenta previa)
  • Placenta separates from the uterine wall (placenta abruptio)
  • Umbilical cord comes through the opening of the birth canal before the baby (umbilical cord prolapse)

Risks

A C-section is a safe procedure. The rate of serious complications is very low. However, certain risks are higher after C-section than after vaginal delivery. These include:

  • Infection of the bladder or uterus
  • Injury to the urinary tract
  • Higher average blood loss. Most of the time, a transfusion is not needed, but risk is higher.

A C-section may also cause problems in future pregnancies. This includes a higher risk for:

  • Placenta previa
  • Placenta growing into the muscle of the uterus and has trouble separating after the baby is born (placenta accreta)
  • Uterine rupture

These conditions can lead to severe bleeding (hemorrhage), which may require blood transfusions or removal of the uterus (hysterectomy).

After the Procedure

Most mothers and infants do well after a C-section.

Women who have a C-section may have a vaginal delivery if another pregnancy occurs, depending on:

  • The type of C-section done
  • Why the C-section was done

Vaginal birth after cesarean (VBAC) delivery is very often successful. However, there is a small risk of uterine rupture, which can harm the mother and the baby. Discuss the benefits and risks of VBAC with your health care provider.

Outlook (Prognosis)

The average hospital stay after C-section is 2 to 3 days. Recovery takes longer than it would from a vaginal birth. You should walk around after the C-section to speed recovery. Pain medicines taken by mouth can help ease discomfort.

References

Berghella V, Landon MB. Cesarean delivery. In: Gabbe SG, Niebyl JR, Simpson JL, et al, eds. Obstetrics: Normal and Problem Pregnancies. 6th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 20.

Cunningham FG, Leveno KJ, Bloom SL, et al. Cesarean delivery and peripartum hysterectomy. In: Cunnigham FG, Leveno KL, Bloom SL, et al, eds. Williams Obstetrics. 23rd ed. New York, NY: McGraw-Hill; 2010:chap 25.

Review Date: 7/28/2014
Reviewed By: Cynthia D. White, MD, Fellow American College of Obstetricians and Gynecologists, Group Health Cooperative, Bellevue, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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