If you have had a C-section
and would like information about how a cesarean affects future deliveries, see
Vaginal Birth After Cesarean (VBAC).
A cesarean section is
the delivery of a baby through a cut (incision) in the mother's belly and
uterus. It is often called a C-section. In most cases,
a woman can be awake during the birth and be with her newborn soon afterward.
See a picture of a
delivery by C-section.
If you are pregnant, chances are good that
you will be able to deliver your baby through the birth canal (vaginal birth).
But there are cases when a C-section is needed for the safety of the mother or
baby. So even if you plan on a vaginal birth, it's a good idea to learn about
C-section, in case the unexpected happens.
A C-section may be
planned or unplanned. In most cases, doctors do cesarean sections because of
problems that arise during labor. Reasons you might need an unplanned C-section
When doctors know about a problem ahead of time, they may
schedule a C-section. Reasons you might have a planned C-section
In some cases, a woman who had a C-section in the past
may be able to deliver her next baby through the birth canal. This is called
vaginal birth after cesarean (VBAC). If you have had a
previous C-section, ask your doctor if VBAC might be an option this time.
In the past 40 years, the rate of cesarean deliveries has jumped
from about 1 out of 20 births to about 1 out of 3 births.1 This trend has caused experts to worry that C-section is
being done more often than it is needed. Because of the risks, experts feel
that C-section should only be done for medical reasons.
Most mothers and
babies do well after C-section. But it is major surgery, so it carries more
risk than a normal vaginal delivery. Some possible risks of C-section
If she gets pregnant again, a woman with a C-section scar
has a small risk of the scar tearing open during labor (uterine rupture). She
also has a slightly higher risk of a problem with the
placenta, such as
Before a C-section, a
needle called an
IV is put in one of the mother's veins to give fluids
and medicine (if needed) during the surgery. She will then get medicine (either
spinal anesthesia) to numb her belly and legs.
general anesthesia, which makes the mother sleep
during the surgery, is only used in an emergency.
anesthesia is working, the doctor makes the incision. Usually it is made low
across the belly, just above the pubic hair line. This may be called a "bikini
cut." Sometimes the incision is made from the navel down to the pubic area. See
a picture of
C-section incisions. After lifting the baby out, the doctor removes the placenta
and closes the incision with stitches.
Most women go home 3 to 5 days after a C-section, but it may take 4 weeks
or longer to fully recover. By contrast, women who deliver vaginally usually go
home in a day or two and are back to their normal activities in 1 to 2 weeks.
Before you go home, a nurse will tell you how to care for the
incision, what to expect during recovery, and when to call the doctor. In
general, if you have a C-section:
Call your doctor if you have any problems or signs of
infection, such as a fever or red streaks or pus from your incision.
Frequently Asked Questions
Learning about cesarean section:
Health Tools help you make wise health decisions or take action to improve your health.
cesarean sections are done with
spinal anesthesia, used to numb sensation in the
abdominal area. Only in an emergency situation or when an epidural or spinal
anesthesia cannot be used or is a problem would fast-acting
general anesthesia be used to make you unconscious for
a cesarean birth.
The hospital may send you instructions on how to
get ready for your surgery, or a nurse may call you with instructions before
In preparation for a cesarean section, your arms are
secured to the table for your safety, and a curtain is hung across your chest.
intravenous (IV) tube is placed in your arm or hand;
you may be given a
sedative through the IV to help you relax. A
catheter is inserted into your
bladder to allow you to pass urine during and after
the surgery. Your upper pubic area may be shaved, and the abdomen and pubic
area are washed with an antibacterial solution. The incision site may be
covered with an adhesive plastic sheet, or drape, to protect the surgical
Before, during, and after a cesarean section, your blood
pressure, heart rate, heart rhythm, and blood oxygen level are closely
monitored. You will also be given a dose of antibiotics to prevent infection
anesthesia is working, a doctor makes the cesarean incision through your lower
uterus. See a picture of
cesarean section incisions. You may notice an intense feeling of pressure or
pulling as the baby is delivered. After delivering your newborn through the
incision, the doctor then removes the
placenta and then closes the uterus and the incision with
layers of stitches.
Right after surgery, you will be taken to a recovery
area where nurses will care for and observe you. You will stay in the recovery
area for 1 to 4 hours, and then you will be moved to a hospital room. In
addition to any special instructions from your doctor, your nurse will explain
information to help you in your recovery.
cesarean section can be done by a doctor who has
specialized training, such as:
If your pregnancy care provider doesn't perform cesareans
and foresees a possible need for a cesarean, you will be referred to a
cesarean-trained doctor ahead of time. Your family medicine doctor,
certified nurse-midwife, or
certified professional midwife can assist with the
surgery and provide your follow-up care.
cesarean deliveries are planned ahead of time. Others
are done when a quick delivery is needed to ensure the mother's and infant's
Some cesarean sections are
planned when a known medical problem would make labor dangerous for the mother
or baby. Medical reasons for a planned cesarean may include:
Many cesarean deliveries are planned ahead of time for
women who have had a cesarean in the past. Medical reasons for a planned repeat
cesarean may include:
Some women request to have a C-section even though there is no medical need for it. Experts don't agree on whether C-sections should be done when there is no medical reason. Most mothers and babies do well after C-section. But it's major surgery, and major surgery has some risks.
cesarean sections are done without planning, after labor has started. Medical
reasons for an emergency cesarean may include:
Cesarean section is considered relatively safe. But it does pose a higher
risk of some complications than does a vaginal delivery. If you have a cesarean
section, expect a longer recovery time than you would have after a vaginal
After cesarean section, the most common complications
for the mother are:
Cesarean risks for the infant include:
While most women recover from both cesarean and vaginal
births without complications, it takes more time and special care to heal from
cesarean section, which is a major surgery. Women who have a cesarean section
without complications spend about 3 days in the hospital, compared with about 2
days for women who deliver vaginally. Full recovery after a cesarean delivery
takes 4 to 6 weeks. Full recovery after a vaginal delivery takes about 1 to 2
Women who have
a uterine cesarean scar have slightly higher long-term risks. These risks,
which increase with each additional cesarean delivery, include:5
After a routine
cesarean section, expect to be monitored closely for
the next 24 hours to make sure that you don't develop any problems. You will
receive pain medicine and will likely be encouraged to begin walking short
distances within 24 hours of surgery. Walking can help relieve gas buildup in
the abdomen. It is usually very uncomfortable to begin walking, but the pain
will decrease in the days after the delivery.
The typical hospital
stay after a cesarean delivery is about 3 days. You can feed and care for your
newborn as you feel able. Before going home, you'll receive postsurgery
instructions, including warning signs of complications. It can take 4 weeks or
more for a cesarean incision to heal, and it isn't unusual to have occasional
pains in the area during the first year after the surgery.
It is important to take care of yourself at home while you are healing.
information about how a cesarean affects future deliveries, see the topic
Vaginal Birth After Cesarean (VBAC).
Call 911 anytime you think you may need emergency care. For example, call if:
Call your doctor now or seek immediate medical care if:
Some women feel shoulder pain for days after a cesarean
section. This is
referred pain, caused by trauma to the abdominal
muscles during the delivery. It goes away on its own during recovery.
If you plan to deliver vaginally
and have concerns about having an unnecessary
cesarean delivery, talk to your doctor or midwife
ahead of time. Ask in what types of situations cesarean section is usually used
and what steps he or she takes to promote a vaginal birth.
Public health experts have urged the North American obstetric community
to reduce the percentage of deliveries done by cesarean, identifying birth
scenarios that may not necessarily require surgical delivery. These
Some doctors are more likely to see a need for a cesarean
than others. For example, what one doctor considers a slow labor may be a
normal labor to another. But all doctors are guided by the common goal of
a healthy labor and delivery for both the mother and her newborn.
American Congress of Obstetricians and Gynecologists
(ACOG) is a nonprofit organization of professionals who provide health care for
women, including teens. The ACOG Resource Center publishes manuals and patient
education materials. The Web publications section of the site has patient
education pamphlets on many women's health topics, including reproductive
health, breast-feeding, violence, and quitting smoking.
CitationsCunningham FG, et al. (2010). Cesarean delivery and
peripartum hysterectomy. In Williams Obstetrics, 23rd
ed., pp. 544–564. New York: McGraw-Hill.American College of Obstetricians and Gynecologists (2000; reaffirmed 2010). Scheduled cesarean delivery and the prevention of vertical transmission of HIV infection. ACOG Committee Opinion No. 234. Washington, DC: American College of Obstetricians and Gynecologists.Kolås T, et al. (2006). Planned cesarean versus planned vaginal delivery at term: Comparison of newborn infant outcomes. American Journal of Obstetrics and Gynecology, 195(6): 1538–43.Tita ATN, et al. (2009). Timing of elective repeat cesarean delivery at term and neonatal outcomes. New England Journal of Medicine, 360(2): 111–120.Scott JR, Porter TF (2008). Cesarean delivery. In RS Gibbs et al., eds., Danforth's Obstetrics and Gynecology, 10th ed., pp. 491–503. Philadelphia: Lippincott Williams and
Wilkins.Other Works ConsultedThorpe JM Jr (2009). Clinical aspects of normal and abnormal labor. In RK Creasy et al., eds., Creasy and Resnik's Maternal Fetal Medicine, 6th ed., pp. 706-724. Philadelphia: Saunders Elsevier.
February 23, 2012
Sarah Marshall, MD - Family Medicine & Deborah A. Penava, BA, MD, FRCSC, MPH - Obstetrics and Gynecology
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