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Why it's done

By Mayo Clinic staff

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.

In addition, some women request elective C-sections with their first babies — typically to avoid labor or the possible complications of vaginal birth. If you're considering an elective C-section, work with your doctor to make the best decision for you and your baby.

Risks Definition
References
  1. Berghella V. Patient information: Cesarean delivery. http://www.uptodate.com/home/index.html. Accessed Aug. 21, 2008.
  2. Berghella V. Cesarean delivery: Postoperative issues. http://www.uptodate.com/home/index.html. Accessed Aug. 21, 2008.
  3. Risks of a Cesarean procedure. American Pregnancy Association. http://www.americanpregnancy.org/labornbirth/cesareanrisks.html. Accessed Aug. 21, 2008.
  4. Reasons for a Cesarean birth. American Pregnancy Association. http://www.americanpregnancy.org/labornbirth/reasonsforacesarean.html. Accessed Aug. 21, 2008.
  5. Creating a positive Cesarean experience. American Pregnancy Association. http://www.americanpregnancy.org/labornbirth/positivecesarean.html. Accessed Aug. 21, 2008.
  6. Landon MB. Cesarean delivery. In: Gabbe SG, et al. Obstetrics: Normal and Problem Pregnancies. 5th ed. Philadelphia, Pa.: Churchill Livingstone Elsevier; 2007. http://www.mdconsult.com/das/book/body/102752869-3/0/1528/181.html?tocnode=54291973&fromURL=181.html#4-u1.0-B978-0-443-06930-7..50021-9_954. Accessed June 23, 2008.
  7. Kennare R, et al. Risks of adverse outcomes in the next birth after a first cesarean delivery. Obstetrics & Gynecology. 2007;109(2):270-276.
  8. Daltveit AK, et al. Cesarean delivery and subsequent pregnancies. Obstetrics & Gynecology. 2008:111(6):1327-1334.
  9. Sun C. Post-lumbar puncture headache. http://www.uptodate.com/home/index.html. Accessed Aug. 22, 2008.
  10. Berghella V. Cesarean delivery: Preoperative issues. http://www.uptodate.com/home/index.html. Accessed Aug. 12, 2008.
  11. About Cesarean childbirth. American College of Surgeons. http://www.facs.org/public_info/operation/cesarean.pdf. Accessed Sept. 9, 2008.
  12. Cesarean birth after care. American Pregnancy Association. http://www.americanpregnancy.org/labornbirth/cesareanaftercare.html. Accessed Sept. 23, 2008.
  13. Cesarean procedure. American Pregnancy Association. http://www.americanpregnancy.org/labornbirth/cesareanprocedure.html. Accessed Sept. 23, 2008.
  14. Berghella V. Cesarean delivery: Technique. http://www.uptodate.com/home/index.html. Accessed Aug. 12, 2008.
  15. Prevention of pertussis, tetanus, and diphtheria among pregnant and postpartum women and their infants: Recommendations of the Advisory Committee on Immunization Practices (ACIP). Centers for Disease Control and Prevention. http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5704a1.htm. Accessed Sept. 22, 2008.
  16. Is it possible to breastfeed after a Cesarean birth? La Leche League. http://www.llli.org//FAQ/cesarean.html. Accessed Sept. 5, 2008.
  17. Grant GJ. Anesthesia for cesarean delivery. http://www.uptodate.com/home/index.html. Accessed Aug. 12, 2008.
  18. Harms RW (expert opinion). Mayo Clinic, Rochester, Minn. Jan. 9, 2009.
  19. Tita AT, et al. Timing of elective repeat Cesarean delivery at term and neonatal outcomes. The New England Journal of Medicine. 2009;360:111.

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