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Cesarean Delivery

A Cesarean section (C-section) is surgery to deliver a baby. The baby is taken out through the mother's abdomen. In the United States, about one in four women have their babies this way. Most C-sections are done when unexpected problems happen during delivery. These include

  • Health problems in the mother
  • The position of the baby
  • Not enough room for the baby to go through the vagina
  • Signs of distress in the baby

C-sections are also more common among women carrying more than one baby.

The surgery is relatively safe for mother and baby. Still, it is major surgery and carries risks. It also takes longer to recover from a C-section than from vaginal birth. After healing, the incision may leave a weak spot in the wall of the uterus. This could cause problems with an attempted vaginal birth later. However, more than half of women who have a C-section can give vaginal birth later.

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 positionAbnormal 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, preeclampsiapreeclampsia or eclampsiaeclampsia

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 previaplacenta previa)
Placenta prematurely separated from uterine wall (placenta abruptioplacenta abruptio)
Umbilical cord comes through the cervix before the baby (umbilical cord prolapse)

Outlook (Prognosis)

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.

To learn more about Cesarean Delivery, please click here to visit ACOG web site