C-section, also known as cesarean delivery, is a procedure in which a birth doctor delivers an infant through an incision in the mother’s abdomen and uterus rather than through the vagina.
Some doctors refer to this as an abdominal delivery.
As of 2017, C-sections represented 31.9 percent of births in the United States, with 1,258,581 babies having C-section births in comparison to 2,684,803 vaginal deliveries.
Some women will choose to have an elective C-section, or C-section on maternal request (CDMR). However, most C-sections occur when vaginal birth would present a risk of seriously harming the mother or child.
In this article, we explain how the procedure works, the possible risks, and what to expect during recovery.
A C-section may be medically necessary for the following reasons:
- Labor is not progressing.
- Multiple gestations, such as twins or triplets, have occurred.
- The fetus experiences an emergency or severe health concern.
- The fetus has hydrocephalus, or excess fluid on the brain.
- The fetus is in the breech or transverse position.
- The baby is too large to travel through the cervix.
- The mother has a contagious virus, such as herpes or HIV, that a vaginal birth would transmit to the infant.
- The mother has complicating conditions, such as diabetes or high blood pressure.
- The mother has a uterine condition or a fibroid obstructing the cervix.
- The placental or umbilical cord has anomalies.
- The mother has previously given birth via C-section.
A cesarean might also occur by maternal choice. A person might choose CDMR for a complex range of reasons, according to a 2017 study, such as:
- a fear of pain during childbirth or anxiety about vaginal delivery
- previous experience
- interactions with healthcare professionals
- a range of social influences, including the media, friends, and family
- a feeling of control over the birthing process
A cesarean is an intensive procedure that requires a longer healing process than a vaginal delivery. Only opt for a CDMR once a doctor provides a clear picture of the risks.
Insurers are likely to decline any claims for reimbursement on a CDMR as the procedure is not medically indicated, or they may only fund up to the cost of a normal delivery if the plan covers childbirth at all.
A C-section comes with risks.
Potential problems the mother can experience include:
- wound infection
- blood loss
- blood clots
- injury to an organ, such as the bowel or bladder
- adverse reactions to medication or anesthesia
- potential complications during future pregnancies
Some women may also experience endometritis, an infection of the lining of the uterus.
Risks to the infant include surgical injury and breathing difficulties, such as transient tachypnea or respiratory distress syndrome.
In a C-section, the birth doctor, or obstetrician, makes a cut across the abdomen and womb while the mother is under an epidural or spinal anesthetic. General anesthesia is not common during a C-section.
The cut is normally between 10 and 20 centimeters (cm) in length.
With the epidural or spinal anesthesia, the lower body will remain pain-free despite the mother not being fully unconscious. They may experience a tugging or pulling sensation.
The obstetrician sometimes sets up a drape to block the view of the operation for the mother, as this could cause distress despite not being painful.
Some hospitals allow the use of a transparent drape. The obstetrician and midwives will keep the mother informed about progress as they operate.
Women who have undergone a C-section with previous babies may be candidates for vaginal birth after C-section (VBAC). However, medical professionals do not recommend this option for all women. Discuss the risks with a healthcare provider.
A C-section may be planned or unplanned for a multitude of reasons.
Below is a fully interactive, 3-D model of cesarean birth.
Explore the model using your mouse pad or touchscreen to understand more about a C-section.
Various options are available for anesthesia during a cesarean.
Discuss these with a healthcare provider. Options include the use of general anesthesia, epidural block, or spinal block. When general anesthesia is used, the patient will be put to sleep for the operation.
With an epidural or spinal block, only the lower half of the body will be numb. During an epidural block, the doctor injects numbing medication into a space in the spine either with or without a tube that can deliver additional medication as needed.
During a spinal block, the doctor injects the medication directly into the spinal fluid.
Following a C-section, a woman and her infant can expect to remain in the hospital for 2–4 days.
The new mother is likely to experience pain at the site of the incision, cramping, and bleeding with or without clots for 4–6 weeks. The severity of these symptoms will vary for different women who have undergone the operation but should improve fairly quickly as time passes.
Visit a doctor with any concerns about the severity of these symptoms or if they continue for longer than expected. The doctor will assess recovery during postoperative visits. These are good opportunities to discuss progress and questions.
Healthcare providers will recommend restricting physical activity on returning home. Until a doctor says that resuming normal activity is safe, typically 4–6 weeks after surgery, they routinely recommend that patients avoid strenuous exercise, lifting heavy objects, placing anything in the vagina, or having sex.
During the recovery period, a woman can take the following steps:
- maintain hydration by drinking plenty of water
- take any medications as directed
- rest when necessary
- provide support to the incision and abdomen with the use of a pregnancy belt or pillow
Report to a healthcare provider any symptoms that could suggest infection or other complications.
These symptoms could include:
- worsening pain
- increased vaginal bleeding
- increased redness at the incision site
- drainage or swelling of the surgical incision
- breast pain with redness or fever
- foul-smelling vaginal discharge
- pain when urinating
Speak with a healthcare provider if you have any additional questions regarding C-section or when trying to decide if it is the right option for you.