Abdominal delivery; Abdominal birth; Cesarean section

The decision to have a C-section delivery depends on:

• Your doctor
• Where you are having the baby
• Previous childbirth
• Your medical history

Some reasons for having C-section instead of vaginal delivery include:

Problems with the baby:

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

Health problems and medical history in the mother:

• Active genital herpes infection
• Large uterine fibroids near the cervix
• HIV infection in the mother
• Previous C-section
• Previous uterine surgery
• Severe illness in the mother, including heart disease, preeclampsia or eclampsia

Problems with labor or delivery:

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

Problems with the placenta or umbilical cord:

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

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

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

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

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 usually successful. However, there is a small risk of uterine rupture, which can harm the mother and the baby. It is important to discuss the benefits and risks of VBAC with your health care provider.

The average hospital stay after C-section is 2 - 4 days. Recovery takes longer than it would from a vaginal birth. You should walk around after the C-section to speed recovery. Pain medication taken by mouth can help ease any pain.

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.

Cunningham FG, Leveno KJ, Bloom SL, et al. Cesarean delivery and peripartum hysterectomy. In: Cunnigham FG, Leveno KL, Bloom SL, et al, eds. Williams Obstetrics. 23rd ed. New York, NY: McGraw-Hill; 2010:chap 25.