Cesarean Section

Cesarean section (C-section) is the surgical delivery of a newborn through an abdominal incision. While vaginal delivery is preferred by patients and doctors, there are occasions when cesarean delivery represents the safest route of delivery for either the baby or the mother. In the U.S., almost one in three deliveries are C-sections.

Typical reasons for C-section include:

  • Failure to progress (Failure of the cervix to dilate despite contraction)
  • Breech presentation (Baby is not head first at the time of delivery)
  • Twin/Triplet pregnancy (When babies are not in a good position to allow labor)
  • Large baby (When the baby is expected to be too large to deliver vaginally)
  • Maternal infection (HIV or active herpes infection)
  • Wellbeing of the baby (Concern for the baby based on an abnormal heart rate or ultrasound may indicate the need for immediate delivery)
  • Placenta problems (Abnormal placement of the placenta may prevent routine labor)
  • Previous C-section (Patients may prefer repeat C-section rather than a trial of labor)

Description of Cesarean Section

C-section are performed in an operating room. The mother may choose to go to sleep (general anesthesia) for the procedure, or more commonly, stay awake using regional anesthesia (spinal block or epidural block). The abdomen is prepared with sterile soap and the patient is covered with a surgical drape. Depending on the circumstances, the surgeon will create an incision on the abdomen this is either vertical (up and down) or bikini incision (side to side above the pubic bone). Next, an incision is made on the uterus in order to deliver the baby. A transverse incision is a side-to-side incision on the uterus. Alternatively, a vertical or Classical incision is an up-and-down incision on the uterus. The type of uterine incision may affect the safety of labor in future pregnancies. In either case, the direction of the incision on the abdomen is not the same as the direction of the incision on the uterus. Once the baby and placenta have been delivered, the uterine and abdominal incisions are closed. After a brief stay in the recovery room, most patients go home two to three days after surgery. 

Risks of Cesarean Section

While C-sections are routinely performed without complications, it is still considered major abdominal surgery. Like every surgery, there is a risk of bleeding, infection or a complication from anesthesia. More specifically, there is a risk of injury to the mother in the adjacent organs or a risk in injuring the baby. There is also the risk that the surgery will affect future pregnancies and may require repeat cesarean delivery. 

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