Cesarean Section

What is a cesarean section?

A cesarean section, or C-section, is the surgical delivery of a baby through an incision in the mother’s lower abdomen (belly) and uterus. The uterus is a pear-shaped organ located in the lower abdominal (pelvic) area where a baby grows during pregnancy. Your doctor may recommend a cesarean section if he or she decides that is a safer method than a vaginal delivery for you, your baby, or both. Sometimes your doctor makes this decision ahead of time and schedules the procedure. In other cases, your doctor makes this decision during labor.

A cesarean section is a major surgery with significant risks and potential complications. You may have less invasive delivery options available depending on your circumstances. You should consider getting a second opinion about all your delivery choices before having a 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 tends to heal better with less bleeding. It may also increase 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

In addition to a cesarean section, your doctor may also perform one or more other procedures. Sometimes a woman knows that she will not have more children and requests a tubal ligation. 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?

A cesarean section is a major surgical procedure that your doctor may recommend if he or she decides it is the safest method of delivery for you, your baby, or both. Your doctor may only consider a cesarean sectionfor you if other delivery options with less risk of complications are not appropriate or have failed. Talk with your doctor about all of your delivery options and consider getting a second opinion.

Your doctor may recommend a cesarean section under the following conditions:

• Cephalopelvic disproportion, a condition in whichthe 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

How is a cesarean section performed?      

An obstetrician-gynecologist (Ob/Gyn) will usually lead the surgical team and perform your cesarean section in a hospital.

A cesarean section 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).