C-section

Send to friend Print this article

Cesarean section

C-section - series

Epidural - series

Definition

A C-section, also called a cesarean section, is the delivery of a baby through a surgical opening in the lower belly area.

Alternative Names

Abdominal delivery; Abdominal birth; Cesarean section

Description

A C-section delivery is performed when a vaginal birth is not possible or is not safe for the mother or child.

Surgery is usually done while the woman is awake but numbed from the chest to the feet. This is done by giving her epidural or spinal anesthesia.

The surgeon make a cut across the belly just above the pubic area. The uterus and amniotic sac are opened, and the baby is delivered.

The health care team clears the baby's mouth and nose of fluids, and the umbilical cord is clamped and cut. The pediatrician or nurse makes sure that the infant's breathing is normal and that the baby is stable.

The mother is awake, and she can hear and see her baby. The father or another support person is often able to be with the mother during the delivery.

Watch this video about:
Cesarean section

Indications

The decision to have a C-section delivery can depend on the obstetrician, the delivery location, and the woman's past deliveries or medical history. Some reasons for having C-section instead of vaginal delivery are:

Reasons related to the baby:

Abnormal heart rate in the baby
Abnormal position of the baby in the uterus such as crosswise (transverse) or feet-first (breech)
Developmental problems such as hydrocephalus or spina bifida
Multiple babies in the uterus (triplet and some twin pregnancies)

Reasons related to the mother:

Active genital herpes infection
Large uterine fibroids low in the uterus near the cervix
HIV infection in the mother
Previous uterine surgery, including myomectomy and previous C-sections
Severe illness in the mother, including heart disease, toxemia, preeclampsia or eclampsia

Problems with labor or delivery:

Baby's head is too large to pass through mother's pelvis (cephalopelvic disproportion)
Prolonged or arrested labor
Very large baby (macrosomia)

Problems with the placenta or umbilical cord:

Placenta attaches in abnormal location (placenta previa)
Placenta prematurely separated from uterine wall (placenta abruptio)
Umbilical cord comes through the cervix before the baby (umbilical cord prolapse)

Risks

A C-section is a safe procedure. The rate of serious complications is extremely 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
Injury to the baby

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

All surgeries carry risks. Risks due to anesthesia may include:

Reactions to medications
Problems breathing

Risks related to surgery in general may include:

Bleeding
Blood clots in the leg or pelvic veins
Infection

Expectations after surgery

Most mothers and infants recover well, with few problems.

Women who have C-section deliveries can have a normal vaginal delivery with later pregnancies, depending on the type of C-section performed and the reason the C-section was performed.

Many women who attempt a vaginal birth after cesarean (VBAC) delivery are successful. However, there is a small risk of uterine rupture associated with VBAC attempts, which can endanger the mother and the baby. It is important to discuss the benefits and risks of VBAC with your obstetric health care provider.

Convalescence

The average hospital stay after C-section is 2 to 4 days. Recovery takes longer than it would from a natural birth. Walking is encouraged the day of surgery to speed recovery. Pain can be managed with medications taken by mouth.

References

Landon MB. Cesarean delivery. In: Gabbe SG, Niebyl JR, Simpson JL, ed. Obstetrics: Normal and Problem Pregnancies. 5th ed. New York, NY: Churchill Livingstone; 2007: Chap.19.

Review Date: 5/2/2008
Reviewed By: Linda Vorvick, MD, Seattle Site Coordinator, Lecturer, Pathophysiology, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine; and Susan Storck, MD, FACOG, Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine; Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Redmond, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 1997-2011, A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.