Childbirth: Is Planning a C-Section a Good Choice?

Overview

A caesarean section is the delivery of a baby through a cut (incision) in the mother's belly and uterus. It's often called a C-section. Sometimes a C-section is needed for the safety of the mother or baby.

In most cases, doctors do a C-section because of problems during labour. For example:

• Labour is slow and hard or stops completely.
• Your baby shows signs of distress, such as a very fast or slow heart rate.
• There's a problem with the placenta or umbilical cord.
• Your baby is too big to be delivered vaginally.

When doctors know about a problem ahead of time, they may schedule a C-section. You may have a planned C-section if:

• Your baby isn't in a head-down position close to your due date.
• You have a health problem that could be made worse by the stress of labour.
• You have an infection that you could pass to your baby during a vaginal birth.
• You're carrying more than one baby.
• You had a C-section before, and you have the same problems this time. Or your doctor or midwife thinks labour might cause your scar to tear.

Personal reasons for planning a C-section

Some women want to schedule a C-section because:

• They worry that their labour pain won't be controlled.
• They're concerned that labour will cause pelvic floor problems, such as incontinence.
• Their partner may be away at the due date (such as on a military deployment), so they want to have the baby sooner.
• They want to attend an important family event (such as a reunion).
• They want to be sure that their own doctor delivers the baby, rather than an on-call doctor. (In some cases, the doctor may suggest a C-section because of his or her schedule.)
• They may feel shy or embarrassed about people seeing them giving birth.

Talk to your doctor about your wishes and concerns. He or she may be able to help you feel more confident about vaginal birth. For example, your doctor could discuss the many ways to control pain during labour. Or the doctor may explain how often pelvic floor problems happen and what can be done to prevent them.

If you're still thinking of planning a C-section, talk to your doctor about reasons for and against a planned C-section.

Most mothers and babies do well after a C-section. But it's major surgery. It has more risks than a vaginal delivery. Because of these risks, experts feel that a C-section should only be done for medical reasons.

Risks of a C-section

Most mothers and babies do well after a C-section. But it's major surgery. It carries more risk than a normal vaginal delivery. Some possible risks include:

• An infection.
• Heavy blood loss.
• Blood clots in the mother's legs or lungs.
• Injury to the mother or the baby.
• Problems from the anesthesia, such as nausea, vomiting, and severe headache.
• Breathing problems in the baby if the baby was delivered before the due date.

If you get pregnant again, your C-section scar has a small risk of the scar tearing open during labour (uterine rupture). You also have a slightly higher risk of a problem with the placenta, such as placenta previa.