Cesarean section


Although cesarean (C-sections) are relatively safe surgical procedures, they should only be performed in appropriate medical circumstances. Some of the most common reasons for a cesarean are:

  • If the baby is in a feet first (breech) position
  • If the baby is in a shoulder first (transverse) position
  • If the baby’s head is too large to fit through the birth canal
  • If labor is prolonged and the mother’s cervix will not dilate to 10 centimeters
  • If the mother has placenta previa, where the placenta is blocking the birth canal
  • If there are signs of fetal distress which is when the fetus is in danger because of decreased oxygen flow to the fetus

Some common causes of fetal distress are:

  • Compression of the umbilical cord
  • Compression of major blood vessels in the mother’s abdomen because of her birthing position
  • Maternal illness due to hypertension, anemia, or heart disease

Like many surgical procedures, cesarean sections require anesthesia. Usually, the mother is given an epidural or a spinal block. Both of these will numb the lower body, but the mother will remain awake. If the baby has to be delivered quickly, as in an emergency, the mother may be given a general anesthetic, which will make her fall asleep.

During the surgery, an incision is made in the lower abdomen followed by an incision made in the uterus. There is no pain associated with either of these incisions because of the anesthesia. The doctor will open the uterus and the amniotic sac. Then the baby is carefully eased through the incision and out into the world. The procedure usually lasts about 20 minutes.

Afterward, the physician delivers the placenta and stitches up the incisions in the uterus and abdominal wall. Usually, the mother is allowed to leave the hospital within a few days, barring complications like wound infections.

One concern that many women have is whether they’ll be able to have a normal delivery after having a cesarean. The answer depends on what the reasons were for having the c-section in the first place. If it was because of a one-time problem, like umbilical cord compression or breech position, then the mother may be able to have a normal birth.

Therefore, as long as the mother has had one or two previous cesarean deliveries with a low-transverse uterine incision, and there are no other indications for a cesarean, she is a candidate for vaginal birth after cesarean, also called VBAC (say as "vee-back").

Cesarean sections are safe, and can even save the lives of both mother and baby during emergency deliveries. Expectant mothers should be prepared for the possibility of having one. Keep in mind, in childbirth, it’s not only the delivery method that matters, but the end result: a healthy mother and baby.

Update Date: 9/12/2011

Updated by: Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine; Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Bellevue, Washington; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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