How to Decide Whether to Have a C Section

Co-authored by Carrie Noriega, MD

Updated: July 1, 2019

Explore this Article Evaluating Whether a C-Section Is Necessary Talking to the Doctor about the Risks Questions & Answers Related Articles References

C-section is short for Cesarean section. A C-section is when the baby is removed directly from the mother’s uterus after the doctor cuts through the abdomen wall and through the wall of the uterus. This done if it is not safe for the mother or baby to have a natural vaginal birth or if the woman elects to have a C-section done instead. When deciding whether to have a C-section, you should discuss the benefits and disadvantages with your doctor to find out what is best for your situation.[1]

Evaluating Whether a C-Section Is Necessary

  1. 1
    Weigh the risks of any pre-existing health conditions you might have. There are some health conditions that can make it safer for you or safer for your baby if you have a C-section. For this reason it is extremely important that your doctor know your complete medical history. Conditions that might lead the doctor to advise a C-section include:[2] [3][4]
    • If you have a heart problem that could make going through a vaginal delivery dangerous for you.
    • If you have high blood pressure that makes it important that the child be delivered immediately. High blood pressure related to a pregnancy is called pre-eclampsia.
    • If you have an infection that could be transmitted to your child during a vaginal birth. Examples include genital herpes and HIV/AIDS.
  2. 2
    Ask your doctor whether the position of the baby or placenta requires a C-section. Sometimes the baby or the placenta is located in the uterus in ways that makes a vaginal birth more risky. Under these circumstances, the doctor may advise against a vaginal birth.[5][6][7]
    • If your baby is breech or transverse, a C-section may be safer. A breech baby is positioned so that the feet or bottom would come out first. A transverse baby is lying in the uterus so that it enters the birth canal sideways with its side or shoulder first. Mothers pregnant with multiples often have one that is not in the normal head-facing down position.
    • If you have two or more babies that share a placenta, you may need a C-section to prevent one of them from not getting enough oxygen during birth.
    • If you have placenta previa, a C-section might be necessary. Placenta previa occurs when the placenta covers your cervix. Because the baby must pass through the cervix to be born, it is dangerous for it to be covered by the placenta.
    • You may also need a C-section if the umbilical cord, through which the baby gets oxygen and nutrients, is squeezed. This can happen if part of the cord goes through the birth canal before the baby. This is dangerous because it means that the oxygen supply to the baby during birth may be restricted.
  3. 3
    Ask your doctor if you or the baby have a physical condition that would make a vaginal birth difficult. Occasionally vaginal deliveries are not possible due to mechanical reasons. These can include:[8][9][10]
    • You have a fractured pelvis or an unusually small pelvis.
    • You have a fibroid that is in your birth canal which would prevent the baby from fitting through.
    • Your baby has an unusually large head.
    • The baby has an anomaly like omphalocele or gastroschisis (the baby's intestine or other abdominal organs are outside of the body), or cystic hygroma (cysts on the baby's head or neck), which would make a vaginal birth dangerous for them.
    • You are in labor with strong contractions, but your cervix is not opening to allow the baby through.
    • The doctor has tried to induce labor, but it was ineffective.
    • You had a C-section previously and the incision that was made into the uterus makes you more vulnerable for a ruptured uterus. This is called a "classical C-section." This is not the case for all women who have had a prior C-section. Many do have successful vaginal births after having caesarean.
  4. 4
    Assess whether your baby is developing properly. If your baby is not getting enough nutrients and oxygen through the umbilical cord, it may not grow and develop at the proper rate. The doctor will track your baby’s development and evaluate whether a C-section is necessary by:[11]
    • Measuring the your baby’s heartbeat
    • Measuring your baby's growth by measuring the size of the uterus from the pubic bone to the top of the uterus. If this measurement is not normal for your gestational weeks, then an ultrasound is used to measure the baby.
    • Checking the blood flow to the baby with a Doppler ultrasound.
    • Measuring your baby’s growth trajectory in the ultrasound images.

Talking to the Doctor about the Risks

  1. 1
    Ask your doctor whether a C-section will be risky for your baby. Many babies are born without complications during a C-section; however, there are risks that should be considered. These include:[12][13]
    • An injury during surgery. This does not happen often, but it is possible that the baby could be injured by the surgical instruments as the doctor cuts through the uterus. Ask your doctor if this is likely to be a significant risk for your baby. Minor cuts occur in about 2% of C-sections.
    • Transient tachypnea. This occurs when the baby’s breathing rate is too fast for the first several days of life. It is more likely after a C-section. If your baby may be having trouble breathing, call emergency responders immediately.
    • Respiratory distress. Babies born by C-section before 39 weeks old are more likely to have lungs that are not yet fully mature. This puts them at a higher risk for breathing problems.
  2. 2
    Evaluate the risks for you. Women who undergo a C-section have a longer recovery after birth than women who give birth vaginally. You are also at a higher risk of complications, including:[14] [15][16][17]
    • Excessive bleeding. Women who undergo C-sections often lose more blood than women undergoing vaginal deliveries.
    • An injury during the surgery. Occasionally the bladder or another nearby organ may be nicked when the doctor cuts through the abdominal wall. If this occurs the doctor may need to do additional surgery to repair the injury. If you have had prior C-sections, ask your doctor about these risks. They increase as the number of C-sections you’ve had increase.
    • A bad reaction to the anesthesia. Tell your doctor if you have previously had any problems with anesthesia. In addition, if you experience bad headaches when you sit up or stand after the delivery, tell your doctor. This may be a reaction to the anesthesia.
    • Blood clots. You are at a higher risk for blood clots in your legs or pelvic organs after a C-section than after a vaginal birth. Ask your doctor what they recommend for preventing this. Your doctor may also recommend that you walk as soon as possible after the birth to help prevent clotting.
    • An infection. The most common areas for infections are the incision or in the uterus. Monitor your incision for signs of infection such as swelling, redness, increasing pain, and discharge coming from the wound. Go to the emergency room if you have signs of a uterine infection, such as a fever, pain in your uterus, or a bad smelling discharge coming from your vagina.
  3. 3
    Don’t get a C-section for convenience. Some people request a C-section because they want to be able to choose a date that is convenient. This is not recommended, both for your health and for the health of your baby. In addition, if you plan to have more children, you would have a higher risk of complications during future pregnancies. This may include:[18] [19]
    • Problems with the placenta.
    • Risk of the scar rupturing during a future vaginal birth.

Community Q&A

Add New Question
  • Question
    Is it possible to to ask the doctor to deliver at 7 months?
    Carrie Noriega, MD
    Obstetrician & Gynecologist
    Obstetrician & Gynecologist
    Expert Answer
    If the pregnancy is healthy the answer is no. Most hospitals now have a policy that elective or planned deliveries can not occur before 39 weeks gestation.
  • Question
    My pregnancy was easy, but my doctor recommended a C-section because the umbilical cord was tangled around my baby. Did I make the safest decision?
    Community Answer
    It's the best decision because it's easier to get the baby out. If it's tangled around your baby's neck and it comes out vaginally, it can tug and be harder to untangle, so a C-section would be the best bet to put minimal stress on your newborn.
  • Question
    Do people living with HIV have to have a c-section?
    Community Answer
    I would recommend it, since HIV exists in bodily fluids inside the body. I think it would be safer that way.
  • Question
    After pregnancy, the child was born but the mother died. How is it possible and what was the mistake that happened?
    Kaycee Young
    Community Answer
    With every procedure comes risks. Something might have been accidentally cut, the mother could've gotten an infection, she could've bled out or any number of other possibilities.
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    • Most c-sections aren’t planned but rather determined by how well the baby or mother is tolerating labor and whether labor is progressing normally; therefore, if you have a lot of questions or concerns about a c-section it is best to talk with your doctor during routine visits. Often, if the decision is made while in labor and there isn’t a lot of time for a full discussion due to the urgency of performing the procedure.

    Article Info


    Categories: Caesarean Section

    In other languages:

    Español: decidir si debes someterte a una cesárea, Italiano: Valutare se Sottoporti ad un Parto Cesareo, Português: Decidir se Você Deve Fazer uma Cesariana, Русский: решить, следует ли делать кесарево сечение

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