What is a cesarean section?

A cesarean section, or C-section, is the delivery of a baby through an incision in the lower abdomen and uterus. The uterus is a pear-shaped organ located in the lower abdominal (pelvic) area where a baby grows during pregnancy. 

Cesarean section is a major surgery that can sometimes be safer than vaginal delivery for the mother, the baby, or both. Doctors sometimes decide during pregnancy that a cesarean section will be needed and schedule it ahead of time. In other cases, doctors decide during labor that a cesarean section is the best way to deliver a baby.

A cesarean section is a major surgery with significant risks and potential complications. You may have less invasive delivery options. Consider getting a second opinion about all your delivery choices if there is time before having a scheduled cesarean section. 

Types of cesarean section

The types of cesarean section procedures vary according to the types of incisions made:

  • Horizontal (transverse) cesarean incisions extend low across the pubic hairline. This is the most common type of cesarean section because it heals better with less bleeding. It also increases the chance of having a successful vaginal delivery with any future pregnancies.
  • Vertical (longitudinal) cesarean incisions extend from the belly button or naval down to the pubic hairline.

Other procedures that may be performed

Doctors sometimes perform a tubal ligation with a cesarean section. This is an option for a woman who knows that she will not have more children. 

Tubal ligation is the surgical closing of a woman’s fallopian tubes. This procedure is a form of birth control, commonly known as “tying the tubes.” A woman who has had a tubal ligation can no longer become pregnant.

Why is a cesarean section performed? 

Your doctor may recommend a cesarean section if it is the safest method of delivery for you, your baby, or both. Your doctor may only consider a cesarean section for you if other delivery options with less risk of complications are not appropriate or have failed. Ask your doctor about all of your delivery options and consider getting a second opinion if there is time before deciding on a cesarean section. 

Cesarean section is performed for the following conditions: 

  • Cephalopelvic disproportion, a condition in which the baby’s head is too large to fit through the mother’s pelvis
  • Labor problems including failure of labor to progress or prolonged labor. This is sometimes called arrested labor.
  • Macrosomia, a very large baby
  • Maternal infection, such as a mother with HIV or active genital herpes
  • Multiple pregnancy, a pregnancy with two or more babies in your uterus
  • Placenta abruptio, in which the placenta detaches from the wall of the uterus before the baby is born
  • Placenta previa, in which the placenta is in an abnormal position, usually too close to or covering the cervix. The cervix is the opening of the uterus.
  • Previous uterine surgery including a previous C-section
  • Problems with the baby, such as an abnormal heart rate, developmental problems (hydrocephalus or spina bifida), or abnormal positioning crosswise (transverse) or feet-first (breech)
  • Severe maternal illness, such as a mother with serious heart disease, toxemia, preeclampsia or eclampsia
  • Umbilical prolapse, an umbilical cord that comes through the vagina before the baby. This can compress the umbilical cord and cause a drop in the baby’s heart rate. 
  • Uterine fibroids near the cervix or the opening of the uterus

Who performs a cesarean section?

An obstetrician-gynecologist (Ob/Gyn) performs a cesarean section. An obstetrician-gynecologist is a doctor who specializes in the medical and surgical care of women's health and pregnancy.

How is a cesarean section performed?

Your cesarean section will be performed in a hospital. It is an open surgery involving an incision that allows your doctor to directly view and access the surgical area. Your doctor will make the incision in your lower abdomen and the wall of your uterus. The incision may be horizontal (transverse) or vertical (longitudinal).