A cesarean delivery, also called a C-section or cesarean birth, is the surgical delivery of a baby through a surgical cut or incision in a woman's abdomen and uterus. After the baby is removed from the womb, the uterus and abdomen are closed with stitches that later dissolve.1
According to the U.S. Centers for Disease Control and Prevention, in 2015, 32% of births were by cesarean delivery—the lowest rate since 2007. Between 1996 and 2008, the number of cesarean deliveries increased by 72%.2
Cesarean delivery may be necessary in the following circumstances:1,3
- Labor is not progressing. Contractions may not open the cervix enough for the baby to move into the vagina for delivery.
- 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 cesarean delivery allows the baby to be delivered quickly to address and resolve the baby's health problems.
- The baby is in the wrong position. Most often when this occurs, the baby is breech, or in a breech presentation, meaning that the baby is coming out feet first instead of head first. The baby may also be in a transverse (sideways) or oblique (diagonal) position.
- The pregnant woman is delivering 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 within the uterus for natural delivery, or if there are other problems.
- The baby is too large. Larger infants are at risk for complications during delivery. These include shoulder dystocia (pronounced dis-TO-she-ah), when the infant's head is delivered through the vagina but the shoulders are stuck.4 Women with gestational diabetes, especially if their blood sugar levels are not well controlled, are at increased risk for having large babies.
- The placenta has problems. 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. These issues can cause problems, such as preventing needed oxygen and nutrients from reaching the fetus or causing vaginal bleeding.5
- 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 specific medical condition. A cesarean delivery 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
Cesarean delivery is a type of surgery, so it has risks and possible complications for both mother and baby.
Possible risks from a cesarean delivery include:1
- 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
It is important to note that these risks also apply, to some degree, to vaginal birth.
A woman who has a cesarean delivery may also have to stay in the hospital longer than a woman who has had a vaginal delivery.
The more cesarean deliveries a woman has, the greater her risk of certain medical problems and problems with future pregnancies, such as uterine rupture and problems with the placenta.6
Some women may want to have a cesarean birth even if vaginal delivery is an option. Women should discuss their options in detail with their health care provider before making a decision about a type of delivery. The decision should consider the impact of the delivery not only on the current pregnancy but also on future pregnancies. The safest method of delivery for both the mother and the fetus is an uncomplicated vaginal delivery.
Regardless of the type of delivery, 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.
- American College of Obstetricians and Gynecologists. (2015). FAQ: Cesarean birth (C-section). Retrieved February 17, 2017, from http://www.acog.org/Patients/FAQs/Cesarean-Birth-C-Section
- Centers for Disease Control and Prevention. (2017). Births: Final data for 2015. National Vital Statistics Reports, 66(1). Retrieved February 20, 2017, from https://www.cdc.gov/nchs/data/nvsr/nvsr66/nvsr66_01.pdf (PDF 1.95 MB)
- American College of Obstetricians and Gynecologists. (2014; reaffirmed 2016). Safe prevention of the primary cesarean delivery. Obstetric Care Consensus No. 1. Obstetrics and Gynecology, 123, 693–711. Retrieved February 28, 2017, from http://www.acog.org/Resources-And-Publications/Obstetric-Care-Consensus-Series/Safe-Prevention-of-the-Primary-Cesarean-Delivery
- Chatfield, J. (2001). ACOG issues guidelines on fetal macrosomia. American Family Physician, 64(1), 169–170.
- American College of Obstetricians and Gynecologists. (2016). FAQ: Bleeding during pregnancy. Retrieved February 20, 2017, from http://www.acog.org/Patients/FAQs/Bleeding-During-Pregnancy
- 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.