C-section - Mayo Clinic (2023)


Cesarean delivery (C-section) is used to deliver a baby through surgical incisions made in the abdomen and uterus.

Planning for a C-section might be necessary if there are certain pregnancy complications. Women who have had a C-section might have another C-section. Often, however, the need for a first-time C-section isn' clear until after labor starts.

If you're pregnant, knowing what to expect during and after a C-section can help you prepare.

Why it's done

Health care providers might recommend a C-section if:

  • Labor isn't progressing normally. Labor that isn't progressing (labor dystocia) is one of the most common reasons for a C-section. Issues with labor progression include prolonged first stage (prolonged dilation or opening of the cervix) or prolonged second stage (prolonged time of pushing after complete cervical dilation).
  • The baby is in distress. Concern about changes in a baby's heartbeat might make a C-section the safest option.
  • The baby or babies are in an unusual position. A C-section is the safest way to deliver babies whose feet or buttocks enter the birth canal first (breech) or babies whose sides or shoulders come first (transverse).
  • You're carrying more than one baby. A C-section might be needed for women carrying twins, triplets or more. This is especially true if labor starts too early or the babies are not in a head-down position.
  • There's a problem with the placenta. If the placenta covers the opening of the cervix (placenta previa), a C-section is recommended for delivery.
  • Prolapsed umbilical cord. A C-section might be recommended if a loop of umbilical cord slips through the cervix in front of the baby.
  • There's a health concern. A C-section might be recommended for women with certain health issues, such as a heart or brain condition.
  • There's a blockage. A large fibroid blocking the birth canal, a pelvic fracture or a baby who has a condition that can cause the head to be unusually large (severe hydrocephalus) might be reasons for a C-section.
  • You've had a previous C-section or other surgery on the uterus. Although it's often possible to have a vaginal birth after a C-section, a health care provider might recommend a repeat C-section.

Some women request C-sections with their first babies. They might want to avoid labor or the possible complications of vaginal birth. Or they might want to plan the time of delivery. However, according to the American College of Obstetricians and Gynecologists, this might not be a good option for women who plan to have several children. The more C-sections a woman has, the greater the risk of problems with future pregnancies.

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Like other types of major surgery, C-sections carry risks.

Risks to babies include:

  • Breathing problems. Babies born by scheduled C-section are more likely to develop a breathing issue that causes them to breathe too fast for a few days after birth (transient tachypnea).
  • Surgical injury. Although rare, accidental nicks to the baby's skin can occur during surgery.

Risks to mothers include:

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  • Infection. After a C-section, there might be a risk of developing an infection of the lining of the uterus (endometritis), in the urinary tract or at the site of the incision.
  • Blood loss. A C-section might cause heavy bleeding during and after delivery.
  • Reactions to anesthesia. Reactions to any type of anesthesia are possible.
  • Blood clots. A C-section might increase the risk of developing a blood clot inside a deep vein, especially in the legs or pelvis (deep vein thrombosis). If a blood clot travels to the lungs and blocks blood flow (pulmonary embolism), the damage can be life-threatening.
  • Surgical injury. Although rare, surgical injuries to the bladder or bowel can occur during a C-section.
  • Increased risks during future pregnancies. Having a C-section increases the risk of complications in a later pregnancy and in other surgeries. The more C-sections, the higher the risks of placenta previa and a condition in which the placenta becomes attached to the wall of the uterus (placenta accreta).

    A C-section also increases the risk of the uterus tearing along the scar line (uterine rupture) for women who attempt a vaginal delivery in a later pregnancy.

How you prepare

For a planned C-section, a health care provider might suggest talking with an anesthesiologist if there are medical conditions that might increase the risk of anesthesia complications.

A health care provider might also recommend certain blood tests before a C-section. These tests provide information about blood type and the level of the main component of red blood cells (hemoglobin). The test results can be helpful in case you need a blood transfusion during the C-section.

Even for a planned vaginal birth, it's important to prepare for the unexpected. Discuss the possibility of a C-section with your health care provider well before your due date.

If you don't plan to have more children, you might talk to your health care provider about long-acting reversible birth control or permanent birth control. A permanent birth control procedure might be performed at the time of the C-section.

What you can expect

Before the procedure

Abdominal incisions used during C-sections

C-section - Mayo Clinic (1)

Abdominal incisions used during C-sections

A C-section includes an abdominal incision and a uterine incision. The abdominal incision is made first. It's either a vertical incision between your navel and pubic hair (left) or, more commonly, a horizontal incision lower on your abdomen (right).

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Uterine incisions used during C-sections

C-section - Mayo Clinic (2)

Uterine incisions used during C-sections

A C-section includes an abdominal incision and a uterine incision. After the abdominal incision, the health care provider will make an incision in the uterus. Low transverse incisions are the most common (top left).

A C-section can be done in various ways. But most C-sections involve these steps:

  • At home. Your health care provider might ask you to shower at home with an antiseptic soap the night before and the morning of your C-section. Don't shave your pubic hair within 24 hours of your C-section. This can increase the risk of a surgical site infection. If your pubic hair needs to be removed, it will be trimmed by the surgical staff just before surgery.
  • At the hospital. Your abdomen will be cleansed. A thin tube (catheter) will likely be placed into your bladder to collect urine. An intravenous line will be placed in a vein in your hand or arm to provide fluid and drugs, including antibiotics to prevent infection.
  • Anesthesia. Most C-sections are done under regional anesthesia, which numbs only the lower part of your body. This allows you to be awake during the procedure. Common choices include a spinal block and an epidural block.

    Some C-sections might require general anesthesia. With general anesthesia, you won't be awake during the birth.

During the procedure

A doctor makes surgical incisions in the abdomen and the uterus to deliver the baby.

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  • Abdominal incision. The doctor makes an incision in the abdominal wall. It's usually done horizontally near the pubic hairline. Or the doctor might make a vertical incision from just below the navel to just above the pubic bone.
  • Uterine incision. The uterine incision is then made — usually horizontally across the lower part of the uterus (low transverse incision). Other types of uterine incisions might be used depending on the baby's position within the uterus and whether there are complications, such as placenta previa or preterm delivery.
  • Delivery. The baby will be delivered through the incisions. The doctor clears the baby's mouth and nose of fluids, then clamps and cuts the umbilical cord. The placenta is then removed from the uterus, and the incisions are closed with sutures.

If you have regional anesthesia, you're likely to be able to hold the baby shortly after delivery.

After the procedure

A C-section usually requires a hospital stay for 2 to 3 days. Your health care provider will discuss pain relief options with you.

Once the anesthesia begins to wear off, you'll be encouraged to drink fluids and walk. This helps prevent constipation and deep vein thrombosis. Your health care team will monitor your incision for signs of infection. The bladder catheter will likely be removed as soon as possible.

You can start breastfeeding as soon as you're ready, even in the delivery room. Ask your nurse or a lactation consultant to teach you how to position yourself and support your baby so that you're comfortable. Your health care team will select medications for your post-surgical pain with breastfeeding in mind.

When you go home

During the C-section recovery process, discomfort and fatigue are common. To promote healing:

  • Take it easy. Rest when possible. Try to keep everything that you and your baby need within reach. For the first few weeks, don't lift more than 25 pounds.
  • Use recommended pain relief. To soothe incision soreness, your health care provider might recommend a heating pad and pain medications that are safe for breastfeeding women and their babies. These include ibuprofen (Advil, Motrin IB, others) and acetaminophen (Tylenol, others).
  • Wait to have sex. To prevent infection, wait at least six weeks to have sex and don't put anything in your vagina after your C-section.
  • Wait to drive. If you're taking narcotics for pain relief, it might take 1 to 2 weeks before you can comfortably apply brakes and twist to check blind spots.

Check your C-section incision for signs of infection. Pay attention to any symptoms. Contact your health care provider if:

  • Your incision is red, swollen or leaking discharge
  • You have a fever
  • You have heavy bleeding
  • You have worsening pain

If you have severe mood swings, loss of appetite, overwhelming fatigue and lack of joy in life shortly after childbirth, you might have postpartum depression. Contact your health care provider if you think you might be depressed, especially if your symptoms don't go away, you have trouble caring for your baby or completing daily tasks, or you have thoughts of harming yourself or your baby.

The American College of Obstetricians and Gynecologists recommends that postpartum care be ongoing. Have contact with your health care provider within three weeks after delivery. Within 12 weeks after delivery, see your health care provider for a postpartum evaluation.

During this appointment your health care provider likely will check your mood and emotional well-being, discuss contraception and birth spacing, review information about infant care and feeding, talk about your sleep habits and issues related to fatigue and do a physical exam, including a pap smear if it's due. This might include a check of your abdomen, vagina, cervix and uterus to make sure you're healing well.

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Why is C-section not preferred? ›

C-section: Cons

A C-section increases the risk for post-delivery ailments such as pain or infection at the incision site and longer-lasting soreness, according to the U.K.'s National Health Service.

Is C-section considered high risk? ›

Having a C-section increases the risk of complications in a later pregnancy and in other surgeries. The more C-sections, the higher the risks of placenta previa and a condition in which the placenta becomes attached to the wall of the uterus (placenta accreta).

What is the most common reason for a woman to have a C-section? ›

The baby's position

Doctors often recommend a c-section if the baby is breech or transverse. A baby is breech when it's positioned to come out with its feet first instead of the head. A transverse presentation means the baby is lying sideways, with its arm or back facing the vaginal opening.

At what age is C-section recommended? ›

You will usually have a planned c-section at 39 weeks of pregnancy. The aim is to do the c-section before you go into labour. Babies born earlier than 39 weeks are more likely to need help with their breathing. Sometimes there's a medical reason for delivering the baby earlier than this.

Are C-section babies less smart? ›

Indeed, the study by Smajlagic and colleagues observed that, compared to children born vaginally, children born by Cesarean section show lower intelligence quotient (IQ) score if they possess certain genetic variation within GRIN2A gene.

Who is at higher risk for C-section? ›

You might need to plan a C-section if you're pregnant with two or more babies or if you have a medical condition or infection. If you run into an emergency during labor, you may also need a C-section.

How long do you stay in hospital after C-section? ›

The average hospital stay after a C-section is 2 to 4 days, and keep in mind recovery often takes longer than it would from a vaginal birth. Walking after the C-section is important to speed recovery and pain medication may be supplied too as recovery takes place.

How long does C-section take to heal? ›

Just like with any surgery, your body needs time to heal afterward. Expect to stay in the hospital for 2 to 4 days after your delivery. If there are complications, your stay will be longer. Give your body 6 to 8 weeks to fully heal.

Does C-section have long term effects? ›

The prevalence of maternal mortality and maternal morbidity is higher after CS than after vaginal birth. CS is associated with an increased risk of uterine rupture, abnormal placentation, ectopic pregnancy, stillbirth, and preterm birth, and these risks increase in a dose-response manner.

What are the disadvantages of C-section? ›

In terms of C-section risks, potential maternal complications include infections of the uterine lining and incision; excessive bleeding or hemorrhage; injury to the bladder or bowel during surgery; negative reactions to anesthesia; and blood clots like deep vein thrombosis (DVT) and pulmonary embolism.

Which week is best for cesarean delivery? ›

Experts recommend that scheduled cesarean delivery be conducted from 39 weeks onwards [5], so that fetal maturity is complete.

Why do some people prefer C-section? ›

Maternal reasons for cesarean preference were classified into six main categories: fear of childbirth, safety concerns related to health risk perceptions, negative previous birth experiences, positive attitudes toward cesarean birth, access to biased information and superstitious beliefs in auspicious birth dates.

What weight should I be for C-section? ›

ACOG says ultrasound is no better than a provider's exam in estimating fetal weight, suspected macrosomia should not be an indication for induction of labor, and planned C-sections shouldn't be performed unless the estimated fetal weight is 10 pounds or more in diabetic women or 11 pounds or more in other women.

Is a planned C-section better than emergency? ›

Most C-sections are unplanned because the need for one doesn't present itself until much closer to labor, or during it. In these cases, moms have been planning for a vaginal birth. But a few weeks, days or even hours before delivery, mom and their doctor decide that a C-section is the safest option.

What should I do the night before my C-section? ›

The Night Before Your C-section

You will not be allowed to eat, drink or smoke after midnight. This includes candy, gum and water. Try to get a good night's sleep. You may brush your teeth in the morning.

Is C-section associated with autism? ›

Babies who were born by caesarean section are 33 per cent more likely to be diagnosed with autism spectrum disorder, according to a new analysis of more than 20 million births.

Do C-section babies cry at birth? ›

Most babies born via elective caesarean section breathe and cry vigorously at birth.

Are C-section babies more attached to their mothers? ›

The bonds that tie a mother to her newborn may be stronger in women who deliver naturally than in those who deliver by cesarean section, according to a study published by Yale School of Medicine researchers in the October issue of Journal of Child Psychology and Psychiatry.

What are the chances of hemorrhaging during C-section? ›

Excessive haemorrhage associated with caesarean section, commonly defined as blood loss in excess of 1000 ml, is frequently underestimated, but is documented as occurring in more than 5-10% of caesarean sections. Common causes are uterine atony, abnormal placentation, uterine trauma and sepsis.

How safe are planned C-sections? ›

While C-sections are generally very safe, they're still major surgeries. Your recovery time will be longer than with a normal vaginal delivery, both in the hospital and afterward.

How common are blood transfusions after C-section? ›

The proportion of women receiving blood transfusion during cesarean section increased (from 3.21% to 7.40%, P < . 001).

How long is bed rest after C-section? ›

“It's recommended that you get up and walk around,” says Dr. Higgins. “We don't want someone lying in bed for two weeks.”

How many hours after C-section can I walk? ›

Returning to Physical Activities After a C-Section

It's important to get out of bed and walk around within 24 hours after surgery. This can help ease gas pains, help you have a bowel movement, and prevent blood clots.

How long should a mother rest after C-section? ›

How long does it take to recover after a c-section? It usually takes about 6 weeks to recover from your c-section but this will depend on your individual situation. If you had any problems during or after your c-section, or if you're looking after other children at home, you may feel you need more time to recover.

What should I avoid after C-section? ›

Things to Avoid:
  • Sexual intercourse until your health care provider tells you that it is safe.
  • The use of tampons or douche.
  • Taking baths until your incision is healed and you are no longer bleeding.
  • Public pools and hot tubs.
  • Lifting anything heavier than your baby.
  • Repeatedly using stairs.

Can I go back to work 3 weeks after C-section? ›

After a C-section, she recommends women take eight weeks off and to avoid heavy activity to prevent complications.

How should I sleep after C-section? ›

The classic back sleeping position

While back sleeping isn't recommended once you're more than 20 weeks pregnant, this position is recommended for those recovering from surgery. It places the least amount of strain and pressure on your incision site and ensures that your body is aligned in a neutral position.

Can C-sections cause problems later in life? ›

A new study shows that a C-section can lead to complications should you find yourself back on the operation table later in life. Surgical complications cover a range of things that can go wrong during an operation. For example, damage to organs, infection, the need to re-operate, or bleeding during the operation.

What organs can be damaged during C-section? ›

What are the risks of having a c-section?
  • Your incision (cut), uterus and other parts of your body, like your belly and bladder, may get infected.
  • You may lose a lot of blood and need a transfusion. ...
  • Organs near the uterus, like the bladder and intestines, may get injured during surgery.

Does C-section affect the brain? ›

The cesarean delivery group in cohort 1 showed significantly lower white matter development in widespread brain regions and significantly lower functional connectivity in the brain default mode network, controlled for a number of potential confounders.

Is C-section considered major surgery? ›

The benefits of planned cesarean birth must be weighed against the risks. Cesarean birth is a major surgery, and has associated risks. Maternal risks — Because cesarean birth involves major surgery and anesthesia, there are some disadvantages compared with vaginal birth.

Do C-section babies look different? ›

C-section babies don't come through the birth canal, so they have an edge in the looks department. Their heads come out nice and round because they don't get squeezed, and their faces don't get swollen like many babies delivered vaginally.

Are C-section babies different? ›

Babies born by Caesarean section have dramatically different gut bacteria to those born vaginally, according to the largest study in the field. The UK scientists say these early encounters with microbes may act as a "thermostat" for the immune system.

Why are C-sections done at 39 weeks? ›

Babies born early (called premature babies) may have more health problems at birth and later in life than babies born on time. This is why it's important to wait until at least 39 weeks for a scheduled c-section.

What is a gentle C-section? ›

What is a 'gentle C-section'? A “gentle C-section” brings elements of a vaginal delivery into the operating room – such as letting the mother watch the birth and hold her newborn right away. A C-section is major surgery. We can't forget that. But we may be able to take a more patient-centered approach.

What takes longer C-section or natural birth? ›

Since a cesarean section is a major surgery, the body will need adequate time to heal following the procedure. Typically, six to eight weeks is required to fully heal from a cesarean section. Vaginal births typically require two to six weeks for full recovery.

Which country has highest C-section rate? ›

The country with the highest rate of C-sections each year is the country of Turkey, according to the most recent statistics.

What weight is considered a big baby? ›

What is a big baby? The medical term for big baby is macrosomia, which literally means “big body.” Some researchers consider a baby to be big when it weighs 4,000 grams (8 lbs., 13 oz.) or more at birth, and others say a baby is big if it weighs 4,500 grams (9 lbs., 15 oz.) or more (Rouse et al.

Is C-section safer for large babies? ›

Under certain circumstances, a C-section birth is the safest option for the mother and child.” These circumstances may include: A large baby that won't fit through the vaginal canal. Problems with a woman's placenta, which can cause dangerous bleeding during birth.

When do you start losing weight after C-section? ›

You should plan to return to your pre-pregnancy weight by 6 to 12 months after delivery. Most women lose half of their baby weight by 6 weeks after childbirth (postpartum). The rest most often comes off over the next several months.

Why do hospitals avoid C-sections? ›

Overuse of c-sections matters because, while often lifesaving in limited circumstances, the surgery also brings serious risks for babies (such as higher rates of infection, respiratory complications, and neonatal intensive care unit stays, as well as lower breastfeeding rates) and for mothers (such as higher rates of ...

Why would you be put to sleep for C-section? ›

General anesthesia is most often used when a C-section is urgent and there isn't time for an epidural or a spinal block. We place a breathing tube through your mouth, down your throat, and into your lungs to help you breathe during the procedure. You'll be asleep during the C-section.

How painful is a planned C-section? ›

Most women experience some discomfort for the first few days after a caesarean, and for some women the pain can last several weeks. You should make sure you have regular painkillers to take at home for as long as you need them, such as paracetamol or ibuprofen.

Is it better to be awake or asleep for C-section? ›

Under most circumstances, undergoing a c-section via Spinal Anesthesia or Epidural Anesthesia (rather than General Anesthesia) is preferred since it involves less risk and has the advantage of allowing you to be awake during your baby's birth.

What to pack in a hospital bag for C-section? ›

C-Section Hospital Bag Checklist
  • Insurance Card and Photo ID.
  • Cesarean Birth Plan.
  • Belly Binder.
  • Feeding Support Pillow.
  • Loose Drawstring Pants or Nightgowns.
  • High-Waisted Underwear.
  • Going Home Outfit.
  • Flip Flops, or slip-on shoes.
Nov 21, 2022

How awake are you during C-section? ›

Most women are awake and simply numbed from the waist down using regional anesthesia (an epidural and/or a spinal block) during a C-section. That way, they are awake to see and hear their baby being born.

Which is safer C-section or normal delivery? ›

Cesarean is often safer than vaginal delivery in case of the danger posed to the mother or baby due to a medical condition and reduces the death rate and illnesses in the mother and baby. Deliveries can be scheduled according to the convenience of the mother (even for relatives).

Why is natural birth better than C-section for the baby? ›

Babies born vaginally are thought to have an edge over those born via cesarean section. They pick up bacteria from their mother's birth canal, which scientists believe helps protect them from asthma, obesity, and other health issues as they grow older.

Which is more risky C-section or normal delivery? ›

For most women, a vaginal birth is safer and healthier. Vaginal birth cuts the risk for many complications. With a vaginal birth, a woman has the following: A lower risk of needing a blood transfusion.

Does C-section affect life? ›

The prevalence of maternal mortality and maternal morbidity is higher after CS than after vaginal birth. CS is associated with an increased risk of uterine rupture, abnormal placentation, ectopic pregnancy, stillbirth, and preterm birth, and these risks increase in a dose-response manner.

How long does C-section take? ›

A caesarean section is an operation to give birth to your baby. Caesarean section surgery usually takes 30-60 minutes, although the entire process takes a few hours. There'll be many people in the operating theatre with you. You can usually have a support person.

Why is C-section rate so high? ›

Indeed, studies have shown that the more physicians are paid for C-sections relative to vaginal births, the higher the C-section rates become. And when these differentials are reduced, C-section rates decrease.

Do C-section babies get sick more often? ›

Children born via C-section had higher risks for all types of clinical infections, but it was most pronounced for gastrointestinal, respiratory, and viral infections.

How are C-section babies different? ›

Babies born by Caesarean section have dramatically different gut bacteria to those born vaginally, according to the largest study in the field. The UK scientists say these early encounters with microbes may act as a "thermostat" for the immune system.

How many C-section can a woman have? ›

However, from the current medical evidence, most medical authorities do state that if multiple C-sections are planned, the expert recommendation is to adhere to the maximum number of three.”

What happens to baby after C-section? ›

They will take you and your baby on the bed to a small ward, which is sometimes called the recovery room. You can usually continue having skin-to-skin contact with your baby while you're in the recovery room. Your midwife will help you find a comfortable position for putting your baby to your breast.

How long do C-section moms stay in the hospital? ›

The average hospital stay after a C-section is 2 to 4 days, and keep in mind recovery often takes longer than it would from a vaginal birth. Walking after the C-section is important to speed recovery and pain medication may be supplied too as recovery takes place.

Can C-section cause problems years later? ›

Some women do experience symptoms related to their C-section scar long after the operation. Some women feel pain, restriction, or a pulling sensation on or around their scar months or even years after surgery. This is normally due to the build-up of scar tissue which can stick to muscles or even organs and cause pain.


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