Susan L. Grant MD and Margaret Klugman RPA
Obstetics and Gynecology Board Certified

8 East 83rd Street
New York, New York 10028
Phone: 212.769.0755
Fax: 212.769.4728

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Caesarean delivery - also known as a C-section - is a surgical procedure used to deliver your baby through an incision in your abdomen. Some C-sections are planned due to pregnancy complications or because you've had a previous C-section. But, in many cases, the need for a first-time C-section doesn't become obvious until labor has already started. Knowing what to expect during the procedure and recovery can help you prepare.

Why it's done

Sometimes a C-section is safer for you or your baby than is a vaginal delivery. Your doctor may recommend a C-section if:

  • Your labor isn't progressing. Stalled labor is the most common reason for a C-section. Perhaps your cervix isn't opening enough despite strong contractions over several hours. Or the baby's head may simply be too big to pass through your birth canal.
  • Your baby's heartbeat suggests reduced oxygen supply. If your baby isn't getting enough oxygen or your doctor is concerned about changes in your baby's heartbeat, he or she may recommend a prompt C-section.
  • Your baby is in an abnormal position. A baby whose feet or buttocks enter the birth canal before the head is in the breech position. If your doctor isn't able to move the baby into a more favorable position before labor begins, you may need a C-section to reduce the risk of complications. A C-section is also needed if your baby is lying horizontally across your uterus.
  • Your baby's head is in the wrong position. If your baby enters the birth canal chin up or with the top of the forehead or face leading the way, he or she may not fit through your pelvis. A C-section may be the safer way to deliver the baby.
  • You're carrying twins, triplets or other multiples. When you're carrying multiple babies, it's common for one or more of the babies to be in an abnormal position. In this case, Caesarean birth is often safer - especially for the second baby.
  • There's a problem with your placenta. If the placenta detaches from your uterus before labor begins (placental abruption) or the placenta covers the opening of your cervix (placenta previa), C-section is often the safer option.
  • There's a problem with the umbilical cord. A C-section may be recommended if a loop of umbilical cord slips through your cervix ahead of your baby or if the cord is compressed by the uterus during contractions.
  • Your baby is very large. Some babies are simply too big to safely deliver vaginally. Typically this is only a factor if you have diabetes.
  • You have a health problem. If you have a condition such as diabetes, heart disease or lung disease, your doctor may induce labor early to reduce the risk of pregnancy-related complications. If the induction isn't successful, you may need a C-section.

In other circumstances, a C-section may be recommended if you have an active genital herpes infection or another condition that your baby might acquire while passing through the birth canal.

  • Your baby has a health problem. A C-section may be safer for babies with certain developmental problems, such as failure of the spine to close properly (spina bifida) or excess fluid in the brain (hydrocephalus).
  • You've had a previous C-section. Depending on the type of incision and other factors, you may be able to attempt a vaginal delivery after a previous C-section. In some cases, however, your doctor may recommend a repeat C-section.

How you prepare

If your C-section is scheduled in advance, your doctor may suggest you talk with an anesthesiologist to discuss your questions about anesthesia and options for pain relief during delivery.

Your doctor may also recommend you have blood tests before your C-section. This is so that information about your blood type and your levels of hemoglobin - the iron-rich protein in red blood cells that gives blood its red color - are available to your health care team during the procedure. This information can be helpful to your medical team in the unlikely event that you need a blood transfusion.

After a C-section, you'll need several weeks to rest and recover. So, before your C-section, consider requesting help at home for the weeks following the birth of your baby. This may include arranging for extra child care if you have older children.

Preparing for the unexpected

Getting the unexpected news that you need a C-section can be stressful, both for you and your partner. And in an emergency, your doctor may not have time to explain the procedure and answer your questions. So, discuss the possibility of a C-section with your doctor well before your due date. Ask questions, share your concerns and review the circumstances that might make a C-section the best option.