Pregnancy and Children

Cesarean Section (C-Section)

Cesarean Birth     Cesarean Birth

Most healthy pregnant women with no risk factors for problems during labor or delivery have their babies vaginally. Still, the rate of babies born by cesarean section (C-section) in the U.S. is on the rise with approximately 1 in 3 babies in the United States being delivered by cesarean section.

Cesarean Section

The following information, adapted from the March of Dimes, and Medem websites, will help you understand what a C-section is and how you may be affected by a C-section.

During a c-section a cut is made in the woman's abdomen and uterus and the baby is taken out of the uterus instead of coming out of the vagina. Most women get assistance with pain management  with spinal or epidural anesthesia during a c-section.

C-section can be a lifesaving operation when either you or your baby face certain problems before or during labor and delivery. Most cesarean sections go well for both the mother and the baby.  A cesarean section is major surgery and should be done only when the health of the mother or baby is at risk.

Many experts think that up to 50% all c-sections are unnecessary and the U.S. government is trying to reduce the rate. There are many reasons why a cesarean birth may be used to deliver your baby. A cesarean delivery may be planned in advance when certain conditions are known and in some cases, if problems arise, the decision is made during labor.  Studies show that the benefits of having a c-section may outweigh the risks when:

  • the mother is carrying more than one baby (twins, triplets, etc.)

  • the mother has health problems including HIV infection, herpes infection, and heart disease

  • the mother has dangerously high blood pressure

  • the mother has problems with the shape of her pelvis

  • there are problems with the placenta.

  • there are problems with the umbilical cord

  • there are problems with the position of the baby (e.g. breech presentation)

  • the baby shows signs of distress (e.g. slowed heart rate)

  • labor does not progress normally and contractions do not open the cervix enough for the baby to move through the vagina

  • the mother has had a previous c-section. Many women who have had a cesarean birth before may be able to give birth vaginally; however, a vaginal delivery after a previous cesarean delivery is not a good option for women when there is a significant risk of rupture of the uterus.

To protect yourself and your baby you should find out why a C-section may be needed and the pros and cons of this surgery.

Cesarean Birth: Some Questions and Answers

Can I choose to have a C-section if I want it?

The answer is maybe and depends on your medical condition and on your health care provider.  Some women may prefer to have a cesarean section instead of a vaginal birth, even without medical need. It may be appealing for both the woman and the health care provider to consider cesarean because it helps them plan their schedules. Some women ask for c-section because they are worried about the pain of vaginal delivery. Others like the convenience of being able to decide when and how to deliver their baby. Still others fear the risks of vaginal delivery including tearing and sexual problems.

Can I have a vaginal birth after I have had a C-section birth?

The answer is maybe and depends on your medical condition and doctor.  Some women who have delivered previous babies by c-section would like to have their next baby vaginally. This is called vaginal delivery after C-section or VBAC. Women give many reasons for wanting a VBAC. Some want to avoid the risks and long recovery of surgery. Others want to experience vaginal delivery.

Studies show that VBACs are more risky for the woman and baby than a repeat c-section. The most serious danger of VBACs is the chance that the c-section scar on the uterus will open up during labor and delivery. This is called uterine rupture. While very rare, uterine rupture is very dangerous for the mother and baby. Less than 1 percent of VBACs lead to uterine rupture.

Choosing to try a VBAC is a difficult decision for many women. If you are interested in a VBAC, talk to your doctor and read up on the subject.

What are the risks involved in a C-section?

A C-section is a major operation with risks from the surgery itself and from anesthesia.

A woman who has a c-section usually takes longer to recover than a woman who has had a vaginal birth. Women can expect to stay 3 to 4 days in the hospital after a C-section. Full recovery usually takes 4 to 6 weeks. Usually, the hospital stay for vaginal birth is 1-2 days with full recovery taking less then a few weeks.

C-sections may contribute to the growing number of babies who are born late preterm, between 34 and 36 weeks gestation. Compared to a full-term baby, an infant born between 34 and 36 weeks gestation is more likely to have problems with breathing, feeding, maintaining body temperature, and jaundice.

How do I make a decision whether or not to have a C-section?

Every pregnancy is different. If you are considering a planned C-section for medical reasons or are interested in asking that your baby be delivered by C-section, talk with the health care provider who will deliver your baby. Carefully consider the risks and benefits for your baby and yourself.

Additional Information

March of Dimes: Cesarean birth for medical reasons

March of Dimes: Cesarean birth by request

Cesarean Birth: What to expect

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