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Cesarean Delivery

(C-Section)

By

Julie S. Moldenhauer

, MD, Children's Hospital of Philadelphia

Last full review/revision Jul 2021| Content last modified Jul 2021
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Cesarean delivery is surgical delivery of a baby by incision through a woman’s abdomen and uterus.

In the United States, up to 30% of deliveries are cesarean.

Doctors use a cesarean delivery when they think it is safer than vaginal delivery for the woman, the baby, or both, as in the following situations:

In the past, after a woman had one cesarean delivery, doctors recommended a cesarean delivery for all subsequent pregnancies. Doctors were concerned that the scar from the incision in the uterus might open (uterine rupture Uterine Rupture Uterine rupture is a spontaneous tearing open of the uterus that may result in the fetus floating in the abdomen. Rupture of the uterus is very rare. It is an emergency requiring immediate treatment... read more ) during labor. However, doctors now realize that the risk of rupture is low after a cesarean delivery if the incision was made in the lower part of the uterus and is horizontal. Thus, if women have had only one previous cesarean delivery and a horizontal incision was made in the lower part of the uterus, they can choose to have a vaginal delivery—called a vaginal birth after cesarean (VBAC). However, if women have had more than one cesarean delivery, most doctors recommend cesarean delivery for all subsequent pregnancies. Women should discuss the risks with their doctor before deciding whether to attempt VBAC. Many centers use checklists to make sure that women and their babies are good candidates for a safe and successful VBAC.

If a woman chooses vaginal delivery after having had one previous cesarean delivery, she should plan to have her baby in a facility equipped to rapidly do a cesarean delivery because

  • Vaginal delivery is successful in only about 60 to 80% of women who have had one previous cesarean delivery.

  • There is a very small risk that the uterus might rupture.

Did You Know...

  • If a woman has had only one previous cesarean delivery with a lower horizontal incision, she can talk with her doctor about the possibility of having a vaginal delivery for her next pregnancy.

An obstetrician, an anesthesiologist, nurses, and sometimes a pediatrician are involved in a cesarean delivery. Use of anesthetics, drugs given intravenously, antibiotics, and blood transfusions helps make a cesarean delivery safe.

For a cesarean delivery, an incision can be made in the upper or lower part of the uterus.

Women are encouraged to walk around soon after a cesarean delivery to reduce the risk of blood clots forming in the legs or pelvis, then traveling to the lungs and blocking arteries there (pulmonary embolism Pulmonary Embolism (PE) Pulmonary embolism is the blocking of an artery of the lung (pulmonary artery) by a collection of solid material brought through the bloodstream (embolus)—usually a blood clot (thrombus) or... read more ).

Cesarean delivery results in more overall pain afterward, a longer hospital stay, and a longer recovery time than vaginal delivery.

More Information

The following is an English-language resources that may be useful. Please note that THE MANUAL is not responsible for the content of this resource.

  • Childbirth Connection: This web site provide tips for having a healthy baby and safe delivery. The importance of medical care before, during, and after delivery is emphasized.

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