Pulling out the baby.
A Caesarean section in progress.
Suturing of the uterus after extraction.
Closed Incision for low transverse abdominal incision after stapling has been completed.There are several types of Caesarean section (CS). An important distinction lies in the type of incision (longitudinal or latitudinal) made on the uterus, apart from the incision on the skin.
The classical Caesarean section involves a midline longitudinal incision which allows a larger space to deliver the baby. However, it is rarely performed today as it is more prone to complications.
The lower uterine segment section is the procedure most commonly used today; it involves a transverse cut just above the edge of the bladder and results in less blood loss and is easier to repair.
An emergency Caesarean section is a Caesarean performed once labour has commenced.
A crash Caesarean section is a Caesarean performed in an obstetric emergency, where complications of pregnancy onset suddenly during the process of labour, and swift action is required to prevent the deaths of mother, child(ren) or both.
A Caesarean hysterectomy consists of a Caesarean section followed by the removal of the uterus. This may be done in cases of intractable bleeding or when the placenta cannot be separated from the uterus.
Traditionally other forms of Caesarean section have been used, such as extraperitoneal Caesarean section or Porro Caesarean section.
a repeat Caesarean section is done when a patient had a previous Caesarean section. Typically it is performed through the old scar.
In many hospitals, especially in Argentina, the United States, United Kingdom, Canada, Norway, Sweden, Finland, Australia, and New Zealand the mother's birth partner is encouraged to attend the surgery to support the mother and share the experience. The anaesthetist will usually lower the drape temporarily as the child is delivered so the parents can see their newborn.
RisksRisks for the motherThe mortality rate for both Caesarian sections and vaginal birth, in the Western world, continues to drop steadily. In 2000, the mortality rate for Caesareans in the United States were 20 per 1,000,000. The UK National Health Service gives the risk of death for the mother as three times that of a vaginal birth. However, it is misleading to directly compare the mortality rates of vaginal and Caesarean deliveries. Women with severe medical conditions, or higher-risk pregnancies, often require a Caesarean section which can distort the mortality figures.
A study published in the 13 February 2007 issue of the Canadian Medical Association Journal found that the absolute differences in severe maternal morbidity and mortality was small, but that the additional risk over vaginal delivery should be considered by women contemplating an elective Caesarean delivery and by their physicians.
As with all types of abdominal surgery, a Caesarean section is associated with risks of post-operative adhesions, incisional hernias (which may require surgical correction) and wound infections. If a Caesarean is performed under emergency situations, the risk of the surgery may be increased due to a number of factors. The patient's stomach may not be empty, increasing the anaesthesia risk. Other risks include severe blood loss (which may require a blood transfusion) and post spinal headaches.
A study published in the June 2006 issue of the journal Obstetrics and Gynecology found that women who had multiple Caesarean sections were more likely to have problems with later pregnancies, and recommended that women who want larger families should not seek Caesarean section as an elective. The risk of placenta accreta, a potentially life-threatening condition, is only 0.13% after two Caesarean sections but increases to 2.13% after four and then to 6.74% after six or more surgeries. Along with this is a similar rise in the risk of emergency hysterectomies at delivery. The findings were based on outcomes from 30,132 Caesarean deliveries.
It is difficult to study the effects of Caesarean sections because it can be difficult to separate out issues caused by the procedure itself versus issues caused by the conditions that require it. For example, a study published in the February 2007 issue of the journal Obstetrics and Gynecology found that women who had just one previous Caesarean section were more likely to have problems with their second birth. Women who delivered their first child by Caesarean delivery had increased risks for malpresentation, placenta previa, antepartum hemorrhage, placenta accreta, prolonged labor, uterine rupture, preterm birth, low birth weight, and stillbirth in their second delivery. However, the authors conclude that some risks may be due to confounding factors related to the indication for the first Caesarean, rather than due to the procedure itself
A Caesarean section, (also C-section, Caesarian section, Cesarean section, Caesar, etc.) is a surgical procedure in which one or more incisions are made through a mother's abdomen (laparotomy) and uterus (hysterotomy) to deliver one or more babies, or, rarely, to remove a dead fetus. A late-term abortion using Caesarean section procedures is termed a hysterotomy abortion and is very rarely performed. The first modern Caesarean section was performed by German gynecologist Ferdinand Adolf Kehrer in 1881.
A Caesarean section is usually performed when a vaginal delivery would put the baby's or mother's life or health at risk, although in recent times it has been also performed upon request for childbirths that could otherwise have been natural. In recent years the rate has risen to a record level of 46% in China and to levels of 25% and above in many Asian and European countries, Latin America, and the USA.
Cesarean Section - Topic Overview
Is this topic for you?
If you have had a C-section and would like information about how a cesarean affects future deliveries, see the topic Vaginal Birth After Cesarean (VBAC).
What is a cesarean section?
A cesarean section is the delivery of a baby through a cut (incision) in the mother’s belly and uterus. It is often called a C-section. In most cases, a woman can be awake during the birth and be with her newborn soon afterward. See a picture of a delivery by C-section .
If you are pregnant, chances are good that you will be able to deliver your baby through the birth canal (vaginal birth). But there are cases when a C-section is needed for the safety of the mother or baby. So even if you plan on a vaginal birth, it’s a good idea to learn about C-section, in case the unexpected happens.
When is a C-section needed?
A C-section may be planned or unplanned. In most cases, doctors do cesarean sections because of problems that arise during labor. Reasons you might need an unplanned C-section include:
Labor is slow and hard or stops completely.
The baby shows signs of distress, such as a very fast or slow heart rate.
A problem with the placenta or umbilical cord puts the baby at risk.
The baby is too big to be delivered vaginally.
When doctors know about a problem ahead of time, they may schedule a C-section. Reasons you might have a planned C-section include:
The baby is not in a head-down position close to your due date.
You have a problem such as heart disease that could be made worse by the stress of labor.
You have an infection that you could pass to the baby during a vaginal birth.
You are carrying more than one baby (multiple pregnancy).
You had a C-section before, and you have the same problems this time or your doctor thinks labor might cause your scar to tear (uterine rupture).
In some cases, a woman who had a C-section in the past may be able to deliver her next baby through the birth canal. This is called vaginal birth after cesarean (VBAC). If you have had a previous C-section, ask your doctor if VBAC might be an option this time.
In the past 40 years, the rate of cesarean deliveries has jumped from about 1 out of 20 births to about 1 out of 4 births.1 This trend has caused experts to worry that C-section is being done more often than it is needed. Because of the risks, experts feel that C-section should only be done for medical reasons.
What are the risks of C-section?
Most mothers and babies do well after C-section. But it is major surgery, so it carries more risk than a normal vaginal delivery. Some possible risks of C-section include:
Infection of the incision or the uterus.
Heavy blood loss.
Blood clots in the mother’s legs or lungs.
Injury to the mother or baby.
Problems from the anesthesia, such as nausea, vomiting, and severe headache.
Breathing problems in the baby if it was delivered before its due date.
Further Reading:Once a C, Always a C? Aiming to Avoid the Scalpel Elective Cesarean: Babies On Demand What to Expect if You Have a Cesarean Delivery C-Section May Affect Future Fertility C-Section No Cure-All for Problem Births Preterm Birth and C-Section Rates Up See All C-Section Topics