Cesarean



What is a c-section?


A c-section, or cesarean section, is the delivery of a baby through a surgical incision in the mother's abdomen and uterus. In certain circumstances, a c-section is scheduled in advance. In others, it's done in response to an unforeseen complication.

Why would I have a scheduled c-section?


Sometimes it's clear that a woman will need a c-section even before she goes into labor. For example, you may require a planned c-section if:

  • You've had a previous cesarean with a "classical" vertical uterine incision (this is relatively rare) or more than one previous c-section. Both of these significantly increase the risk that your uterus will rupture during a vaginal delivery.
  • If you've had only one previous c-section with a horizontal uterine incision, you may be a good candidate for a vaginal birth after cesarean, or VBAC. (Note that the type of scar on your belly may not match the one on your uterus.)
  • You've had some other kind of invasive uterine surgery, such as a myomectomy (the surgical removal of fibroids).
  • You're carrying more than one baby. (Some twins can be delivered vaginally, but most of the time higher-order multiples require a c-section.)
  • Your baby is expected to be very large (a condition known as macrosomia). This is particularly true if you're diabetic or you had a previous baby of the same size or smaller who suffered serious trauma during a vaginal birth.
  • Your baby is in a breech (bottom first) or transverse (sideways) position. (In some cases, such as a twin pregnancy in which the first baby is head down but the second baby is breech, the breech baby may be delivered vaginally.)
  • You have placenta previa (when the placenta is so low in the uterus that it covers the cervix).
  • You have an obstruction, such as a large fibroid, that would make a vaginal delivery difficult or impossible.
  • The baby has a known malformation or abnormality that would make a vaginal birth risky, such as some cases of open neural tube defects.
  • You're HIV-positive, and blood tests done near the end of pregnancy show that you have a high viral load.

Note that your caregiver will schedule your surgery for no earlier than 39 weeks -- unless there is a medical reason to do so – in order to make sure the baby is mature enough to be born healthy.