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What is a C-section?

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A C-section, short for cesarean section, is also called cesarean birth. Cesarean birth is the delivery of a baby through surgical cuts in a woman’s abdomen and uterus. The uterus is then closed with stitches that later dissolve. Stitches or staples also close the skin on the belly.1

According to the U.S. Centers for Disease Control and Prevention, in 2011, almost 33% of births were by cesarean delivery.1 According to the Agency for Healthcare Research and Quality, the number of cesarean deliveries increased by 72% between 1997 and 2008.2

When is cesarean delivery needed?

Cesarean delivery may be necessary in the following circumstances:

  • A pregnancy with two or more fetuses (multiple pregnancy). A cesarean delivery may be needed if labor has started too early (preterm labor), if the fetuses are not in good positions in the uterus for natural delivery, or if there are other problems.
  • Labor is not progressing. Contractions may not open the cervix enough for the baby to move into the vagina.
  • The infant’s health is in danger. The umbilical cord, which connects the fetus to the uterus, may become pinched, or the fetus may have an abnormal heart rate. In these cases, a C-section allows the baby to be delivered quickly to address and resolve the baby’s health problems.
  • Problems with the placenta. Sometimes the placenta is not formed or working correctly, is in the wrong place in the uterus, or is implanted too deeply or firmly in the uterine wall. This can cause problems, such as depriving the fetus of needed oxygen and nutrients or vaginal bleeding.
  • The baby is too large. Women with gestational diabetes, especially if their blood sugar levels are not well controlled, are at increased risk for having large infants. And larger infants are at risk for complications during delivery. These include shoulder dystocia, when the infant’s head is delivered through the vagina but the shoulders are stuck.
  • The baby is breech, or in a breech presentation, meaning the baby is coming out feet first instead of head first.
  • The mother has an infection, such as HIV or herpes, that could be passed to the baby during vaginal birth. Cesarean delivery could help prevent transmission of the virus to the infant.
  • The mother has a medical condition. A C-section enables the health care provider to better manage the mother’s health issues.

Women who have a cesarean delivery may be given pain medication with an epidural block, a spinal block, or general anesthesia. An epidural block numbs the lower part of the body through an injection in the spine. A spinal block also numbs the lower part of the body but through an injection directly into the spinal fluid. Women who receive general anesthesia, often used for emergency cesarean deliveries, will not be awake during the surgery.1

What are the risks of a C-section?

Cesarean birth is a type of surgery, meaning it has risks and possible complications for both mother and infant.

Possible risks from a C-section (which are also associated with vaginal birth) include3:

  • Infection
  • Blood loss
  • Blood clots in the legs, pelvic organs, or lungs
  • Injury to surrounding structures, such as the bowel or bladder
  • Reaction to medication or anesthesia used

A woman who has a C-section also may have to stay in the hospital longer. The more C-sections a woman has, the greater her risk for certain medical problems and problems with future pregnancies, such as uterine rupture and problems with the placenta.4

Can a C-section be requested?

Some women may want to have a cesarean birth even if vaginal delivery is an option. Women should discuss this option in detail with their health care provider before making a final decision about a C-section.

As is true for vaginal births, unless there is a medical necessity, delivery should not occur before 39 weeks of pregnancy (called full term). Watch this video to learn why it is important for the mother’s and infant’s health to wait until at least 39 weeks to deliver unless there is a medical reason to do so earlier.

A text alternative is available at http://www.nichd.nih.gov/ncmhep/initiatives/is-it-worth-it/transcripts/Pages/default.aspx#full.


  1. Centers for Disease Control and Prevention. (2013). Births: Final data for 2011. National Vital Statistics Reports, 62(1). Retrieved December 26, 2013, from http://www.cdc.gov/nchs/data/nvsr/nvsr62/nvsr62_01.pdf (PDF – 1.62 MB) [top]
  2. Agency for Healthcare Research and Quality. (2011). Use of episiotomy and forceps during childbirth down, C-section rates up. Retrieved July 31, 2012, from http://www.ahrq.gov/news/nn/nn042811.htm [top]
  3. American College of Obstetricians and Gynecologists. (2011). FAQs: Cesarean birth. Retrieved July 22, 2013, from http://www.acog.org/~/media/For%20Patients/faq006.pdf?dmc=1&ts=20120725T1708145870External Web Site Policy (PDF – 336 KB) [top]
  4. Spong, C. Y., Berghella, V., Wenstrom, K. D., Mercer, B. M., & Saade, G. R. (2012). Preventing the first cesarean delivery: Summary of a joint Eunice Kennedy Shriver National Institute of Child Health and Human Development, Society for Maternal-Fetal Medicine, and American College of Obstetricians and Gynecologists Workshop. Obstetrics & Gynecology,120(5), 1181–1193. [top]

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