Alamance Regional Medical Center, Burlington, North Carolina

Medical Encyclopedia

c-section

Alternative Names
cesarean section, abdominal delivery, abdominal birth

Definition

A Cesarean birth, or Cesarean birth, is the delivery of a baby through an incision in the mother's abdomen. A baby is delivered this way if ordinary vaginal delivery would put health of a mother or baby at risk for any of several reasons.

Who is a candidate for the procedure?

A Cesarean birth may be done to help the mother if:

the baby's head is too large to pass through her pelvis
labor has gone on too long without enough progress
the baby is in a position that will make a vaginal birth difficult
the mother is having medical problems, such as kidney failure or high blood pressure that can signal a dangerous health condition called pre-eclampsia
the mother is bleeding internally from a traumatic event
the mother has a history of infertility, especially if she is older than age 40
an earlier pregnancy resulted in the birth of a stillborn baby
serious health problems, such as cancer or a coma, make it doubtful that a mother can withstand the stress of labor
a mother's pelvis is unusually shaped
a mother has had two or more previous Cesarean births
a mother's water breaks and her baby is not in a head-down position for delivery

A c-Cesarean birth may be done to help the baby if:

the baby is not getting enough oxygen
the baby's heart rate rises to an unhealthy level due to problems such as a fever in the mother or infection in the baby
the heart rate drops too low, possibly because the umbilical cord is wrapped around the baby's neck
he or she is part of a multiple birth, such as twins or triplets
there is placenta abruptio, where the placenta tears away from the uterus too early
there is placenta previa, which happens when the placenta is touching or blocking the outlet of the uterus. An attenpt to deliver a baby naturally under this condition could result in massive bleeding
the baby has defects or health problems that may cause distress during labor
the baby has not been growing at a healthy rate, a condition known as intrauterine growth retardation
the mother has an active herpes outbreak in or near her vagina

How is the procedure performed?

The woman is usually awake for a Cesarean birth. Spinal or epidural anesthesia may be used to prevent pain in the lower half of the body. However, on occasion, general anesthesia must be used—especially in emergency cases.

The surgeon makes an incision just above the pubic hair or cuts through a previous abdominal incision. He or she must cut through many layers of the mother's tissues to get to the uterus. Then the lower portion of the uterus close to the bladder is opened. The baby's head is brought out through this incision, followed by the rest of his or her body, the umbilical cord, and the placenta.

The uterus and all the layers of tissue and skin on top of it are then closed with stitches or staples.

What happens right after the procedure?

After the Cesarean birth, the mother:

may try to breastfeed in the recovery room if she and the baby are doing well
will probably get antibiotics and intravenous (IV) fluids for 24 hours
will be encouraged to walk as soon as possible
may be given pain relievers through an IV pump or shots. Once the mother can eat food, she can take pills instead
usually stays in the hospital for at least 48 hours, depending on whether she or the baby has any more problems

What happens later at home?

It takes longer to recover from a Cesarean birth than from a vaginal birth.

Once she is home, a woman should:

try to get some help from friends and family or from paid employees, for the first few days
try to use the stairs very little for the first week
walk daily to keep blood clots from forming in her legs
use a heating blanket on the incision, if needed to provide comfort
keep taking prenatal vitamins
eat a balanced diet with plenty of fluids to prevent constipation

What are the potential complications after the procedure?

Possible complications include:

problems with the anesthetic, such as breathing problems or drug reactions
reactions to medicines, such as antibiotics or pain relievers
bleeding
a higher risk that blood transfusions will be needed
a pelvic or wound infection
bladder infection or trauma to the bladder

Any new or worsening symptoms should be reported to the healthcare professional.

Author:Eva Martin, MD
Date Written:08/05/99
Medical Review:Reginald Finger, MD
Date Written:10/24/2006
Reviewer:Walt Larimore, MD
Date Reviewed:10/27/2006
Contributors
Potential conflict of interest information for reviewers available on request