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C-section

Abdominal delivery; Abdominal birth; Cesarean birth; Pregnancy - cesarean

A C-section is the delivery of a baby by making an opening in the mother's lower belly area. It is also called a cesarean delivery.

Description

A C-section delivery is done when it is not possible or safe for the mother to deliver the baby through the vagina.

The procedure is most often done while the woman is awake. The body is numbed from the chest to the feet using epidural or spinal anesthesia.

1. The surgeon makes a cut across the belly just above the pubic area.

2. The womb (uterus) and amniotic sac are opened.

3. The baby is delivered through this opening.

The health care team clears fluids from the baby's mouth and nose. The umbilical cord is cut. The health care provider will make sure that the infant's breathing is normal and other vital signs are stable.

The mother is awake during the procedure so she will be able to hear and see her baby. In many cases, the woman is able to have a support person with her during the delivery.

The surgery takes about 1 hour.

Why the Procedure Is Performed

There are many reasons why a woman may need to have a C-section instead of a vaginal delivery. The decision will depend on your doctor, where you are having the baby, your previous deliveries, and your medical history.

Problems with the baby may include:

  • Abnormal heart rate
  • Abnormal position in the womb, such as crosswise (transverse) or feet-first (breech)
  • Developmental problems, such as hydrocephalus or spina bifida
  • Multiple pregnancy (triplets or twins)

Health problems in the mother may include:

  • Active genital herpes infection
  • Large uterine fibroids near the cervix
  • HIV infection in the mother
  • Past C-section
  • Past surgery on the uterus
  • Severe illness, such as heart disease, preeclampsia or eclampsia

Problems at the time of labor or delivery may include:

  • Baby's head is too large to pass through the birth canal
  • Labor that takes too long or stops
  • Very large baby
  • Infection or fever during labor

Problems with the placenta or umbilical cord may include:

  • Placenta covers all or part of the opening to the birth canal (placenta previa)
  • Placenta separates from the uterine wall (placenta abruptio)
  • Umbilical cord comes through the opening of the birth canal before the baby (umbilical cord prolapse)

Risks

A C-section is a safe procedure. The rate of serious complications is very low. However, certain risks are higher after C-section than after vaginal delivery. These include:

  • Infection of the bladder or uterus
  • Injury to the urinary tract
  • Higher average blood loss

Most of the time, a transfusion is not needed, but risk is higher.

A C-section may also cause problems in future pregnancies. This includes a higher risk for:

  • Placenta previa
  • Placenta growing into the muscle of the uterus and has trouble separating after the baby is born (placenta accreta)
  • Uterine rupture

These conditions can lead to severe bleeding (hemorrhage), which may require blood transfusions or removal of the uterus (hysterectomy).

After the Procedure

Most women will remain in the hospital for 2 to 3 days after a C-section. Take advantage of the time to bond with your baby, get some rest, and receive some help with breastfeeding and caring for your baby.

Recovery takes longer than it would from a vaginal birth. You should walk around after the C-section to speed recovery. Pain medicines taken by mouth can help ease discomfort.

Recovery after a C-section at home is slower than after a vaginal delivery. You may have bleeding from your vagina for up to 6 weeks. You will need to learn to care for your wound.

Outlook (Prognosis)

Most mothers and infants do well after a C-section.

Women who have a C-section may have a vaginal delivery if another pregnancy occurs, depending on:

  • The type of C-section done
  • Why the C-section was done

Vaginal birth after cesarean (VBAC) delivery is very often successful. Not all hospitals or providers offer the option of VBAC. There is a small risk of uterine rupture, which can harm the mother and the baby. Discuss the benefits and risks of VBAC with your provider.

References

Berghella V, Mackeen AD, Jauniaux ERM. Cesarean delivery. In: Gabbe SG, Niebyl JR, Simpson JL, et al, eds. Obstetrics: Normal and Problem Pregnancies. 7th ed. Philadelphia, PA: Elsevier; 2017:chap 19.

Hull AD, Resnik R. Placenta previa, placenta accreta, abruptio placentae, and vasa previa. In: Creasy RK, Resnik R, Iams JD, Lockwood CJ, Moore TR, Greene MF, eds. Creasy and Resnik's Maternal-Fetal Medicine: Principles and Practice. 7th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 46.

    • Cesarean section

      Cesarean section

      Animation

    •  

      Cesarean section - Animation

      Although cesarean (C-sections) are relatively safe surgical procedures, they should only be performed in appropriate medical circumstances. Some of the most common reasons for a cesarean are. If the baby is in a feet first (breech) position. If the baby is in a shoulder first (transverse) position. If the baby's head is too large to fit through the birth canal. If labor is prolonged and the mother's cervix will not dilate to 10 centimeters. If the mother has placenta previa, where the placenta is blocking the birth canal. If there are signs of fetal distress which is when the fetus is in danger because of decreased oxygen flow to the fetus. Some common causes of fetal distress are. Compression of the umbilical cord. Compression of major blood vessels in the mother's abdomen because of her birthing position. Maternal illness due to hypertension, anemia, or heart disease. Like many surgical procedures, cesarean sections require anesthesia. Usually, the mother is given an epidural or a spinal block. Both of these will numb the lower body, but the mother will remain awake. If the baby has to be delivered quickly, as in an emergency, the mother may be given a general anesthetic, which will make her fall asleep. During the surgery, an incision is made in the lower abdomen followed by an incision made in the uterus. There is no pain associated with either of these incisions because of the anesthesia. The doctor will open the uterus and the amniotic sac. Then the baby is carefully eased through the incision and out into the world. The procedure usually lasts about 20 minutes. Afterward, the physician delivers the placenta and stitches up the incisions in the uterus and abdominal wall. Usually, the mother is allowed to leave the hospital within a few days, barring complications like wound infections. One concern that many women have is whether they'll be able to have a normal delivery after having a cesarean. The answer depends on what the reasons were for having the c-section in the first place. If it was because of a one-time problem, like umbilical cord compression or breech position, then the mother may be able to have a normal birth. Therefore, as long as the mother has had one or two previous cesarean deliveries with a low-transverse uterine incision, and there are no other indications for a cesarean, she is a candidate for vaginal birth after cesarean, also called VBAC (say as vee-back). Cesarean sections are safe, and can even save the lives of both mother and baby during emergency deliveries. Expectant mothers should be prepared for the possibility of having one. Keep in mind, in childbirth, it's not only the delivery method that matters, but the end result; a healthy mother and baby.

    • C-section

      C-section

      Animation

    •  

      C-section - Animation

      When it's not possible or safe for a woman to deliver a baby naturally through her vagina, she will need to have her baby delivered surgically, a procedure referred to as cesarean section, or C-section. I know this is a controversial topic recently, sometimes people talk C-sections being done too often. That may be true, but when it is necessary, it can be life saving for mother or baby. A C-section is the delivery of a baby through a surgical opening in the mother's lower belly area, usually around the bikini line. The procedure is most often done while the woman is awake. The body is numbed from the chest to the feet using epidural, or spinal, anesthesia. The surgeon usually makes a cut or incision across the belly just above the pubic area. The surgeon opens the womb, or uterus, and the amniotic sac, then delivers the baby. A woman may have a C-section if there are problems with the baby, such as an abnormal heart rate, abnormal positions of the baby in the womb, developmental problems in the baby, a multiple pregnancy like triplets, or when there are problems with the placenta or umbilical cord. A C-section may be necessary if the mother has medical problems, such as an active genital herpes infection, large uterine fibroids near the cervix, or if she is too weak to deliver due to severe illness. Sometimes a delivery that takes too long, caused by problems like getting the baby's head through the birth canal, or in the instance of a very large baby may make a C-section necessary. Having a C-section is a safe procedure. The rate of complications is very low. However, there are some risks, including infection of the bladder or uterus, injury to the urinary tract, and injury to the baby. A C-section may also cause problems in future pregnancies. The average hospital stay after a C-section is 2 to 4 days, and keep in mind recovery often takes longer than it would from a vaginal birth. Walking after the C-section is important to speed recovery and pain medication may be supplied too as recovery takes place. Most mothers and infants do well after a C-section, and often, a woman who has a C-section may have a vaginal delivery if she gets pregnant again.

    • Cesarean section

      Cesarean section - illustration

      1. The uterus is exposed through the abdominal wall, and an incision is made in the uterine covering. 2. The muscles of the uterus are separated, producing a hole for the delivery of the infant. 3. The infant is delivered through the opening in the uterine wall, after which, the uterus is stitched closed.

      Cesarean section

      illustration

    • C-Section - Series

      C-Section - Series

      Presentation

    • Cesarean section

      Cesarean section - illustration

      There are many reasons to deliver a baby by Cesarean section, such as abnormal position of the baby, or abnormalities of the placenta and umbilical cord.

      Cesarean section

      illustration

    • Cesarean section

      Animation

    •  

      Cesarean section - Animation

      Although cesarean (C-sections) are relatively safe surgical procedures, they should only be performed in appropriate medical circumstances. Some of the most common reasons for a cesarean are. If the baby is in a feet first (breech) position. If the baby is in a shoulder first (transverse) position. If the baby's head is too large to fit through the birth canal. If labor is prolonged and the mother's cervix will not dilate to 10 centimeters. If the mother has placenta previa, where the placenta is blocking the birth canal. If there are signs of fetal distress which is when the fetus is in danger because of decreased oxygen flow to the fetus. Some common causes of fetal distress are. Compression of the umbilical cord. Compression of major blood vessels in the mother's abdomen because of her birthing position. Maternal illness due to hypertension, anemia, or heart disease. Like many surgical procedures, cesarean sections require anesthesia. Usually, the mother is given an epidural or a spinal block. Both of these will numb the lower body, but the mother will remain awake. If the baby has to be delivered quickly, as in an emergency, the mother may be given a general anesthetic, which will make her fall asleep. During the surgery, an incision is made in the lower abdomen followed by an incision made in the uterus. There is no pain associated with either of these incisions because of the anesthesia. The doctor will open the uterus and the amniotic sac. Then the baby is carefully eased through the incision and out into the world. The procedure usually lasts about 20 minutes. Afterward, the physician delivers the placenta and stitches up the incisions in the uterus and abdominal wall. Usually, the mother is allowed to leave the hospital within a few days, barring complications like wound infections. One concern that many women have is whether they'll be able to have a normal delivery after having a cesarean. The answer depends on what the reasons were for having the c-section in the first place. If it was because of a one-time problem, like umbilical cord compression or breech position, then the mother may be able to have a normal birth. Therefore, as long as the mother has had one or two previous cesarean deliveries with a low-transverse uterine incision, and there are no other indications for a cesarean, she is a candidate for vaginal birth after cesarean, also called VBAC (say as vee-back). Cesarean sections are safe, and can even save the lives of both mother and baby during emergency deliveries. Expectant mothers should be prepared for the possibility of having one. Keep in mind, in childbirth, it's not only the delivery method that matters, but the end result; a healthy mother and baby.

    • C-section

      Animation

    •  

      C-section - Animation

      When it's not possible or safe for a woman to deliver a baby naturally through her vagina, she will need to have her baby delivered surgically, a procedure referred to as cesarean section, or C-section. I know this is a controversial topic recently, sometimes people talk C-sections being done too often. That may be true, but when it is necessary, it can be life saving for mother or baby. A C-section is the delivery of a baby through a surgical opening in the mother's lower belly area, usually around the bikini line. The procedure is most often done while the woman is awake. The body is numbed from the chest to the feet using epidural, or spinal, anesthesia. The surgeon usually makes a cut or incision across the belly just above the pubic area. The surgeon opens the womb, or uterus, and the amniotic sac, then delivers the baby. A woman may have a C-section if there are problems with the baby, such as an abnormal heart rate, abnormal positions of the baby in the womb, developmental problems in the baby, a multiple pregnancy like triplets, or when there are problems with the placenta or umbilical cord. A C-section may be necessary if the mother has medical problems, such as an active genital herpes infection, large uterine fibroids near the cervix, or if she is too weak to deliver due to severe illness. Sometimes a delivery that takes too long, caused by problems like getting the baby's head through the birth canal, or in the instance of a very large baby may make a C-section necessary. Having a C-section is a safe procedure. The rate of complications is very low. However, there are some risks, including infection of the bladder or uterus, injury to the urinary tract, and injury to the baby. A C-section may also cause problems in future pregnancies. The average hospital stay after a C-section is 2 to 4 days, and keep in mind recovery often takes longer than it would from a vaginal birth. Walking after the C-section is important to speed recovery and pain medication may be supplied too as recovery takes place. Most mothers and infants do well after a C-section, and often, a woman who has a C-section may have a vaginal delivery if she gets pregnant again.

    • Cesarean section

      Cesarean section - illustration

      1. The uterus is exposed through the abdominal wall, and an incision is made in the uterine covering. 2. The muscles of the uterus are separated, producing a hole for the delivery of the infant. 3. The infant is delivered through the opening in the uterine wall, after which, the uterus is stitched closed.

      Cesarean section

      illustration

    • C-Section - Series

      Presentation

    • Cesarean section

      Cesarean section - illustration

      There are many reasons to deliver a baby by Cesarean section, such as abnormal position of the baby, or abnormalities of the placenta and umbilical cord.

      Cesarean section

      illustration

    Self Care

     

    Review Date: 4/19/2018

    Reviewed By: John D. Jacobson, MD, Professor of Obstetrics and Gynecology, Loma Linda University School of Medicine, Loma Linda Center for Fertility, Loma Linda, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

    The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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