C-sections - everything you need to know
A caesarean section (c-section) is an operation to deliver your baby. A doctor makes a cut just below your bikini line, through your abdomen and womb, and lifts your baby out through it.
You may have a planned (elective) c-section if you know you will need a c-section before you go into labour.
You may have an unplanned (emergency) c-section if this is the safest way to deliver your baby.
About 1 in 4 women who give birth in the UK have a c-section. Most of these are emergency c-sections.
What is a planned c-section?
Sometimes, a c-section may be safer for you or your baby than a vaginal birth. For example, your doctor or midwife may offer you a planned c-section if:
- there are problems with the placenta, such as a low-lying placenta (placenta praevia)
- your baby is lying in a difficult position for labour, such as bottom down (breech)
- you are expecting twins who share a placenta or if either baby is lying in a difficult position for labour
- you are expecting more than 2 babies.
If you have HIV or genital herpes, your doctor will explain your birth options. Some women may need a c-section to reduce the risk of passing the virus to the baby.
“Don’t be afraid to ask your consultant for more information. I wasn’t well informed about my placenta praevia and unfortunately was one of the small minority of women whose placenta haemorrhages. I felt this wasn’t clearly explained enough as a risk and I could have been better prepared.”
If you are offered a c-section because of medical reasons, it is your choice whether to have one or not. You do not have to have one if you don’t want one.
You may want to have a c-section, even if there’s no medical need. Read more about your options for giving birth.
If you decide to have a planned c-section, you will see an obstetrician. This is a doctor who specialises in care during pregnancy, labour and after birth. They will explain the benefits and risks of a c-section and your other birth options. You will also see a midwife at your antenatal appointments where you can discuss your options.
You will usually have a planned c-section at 39 weeks of pregnancy. The aim is to do the c-section before you go into labour. Babies born earlier than 39 weeks are more likely to need help with their breathing. Sometimes there’s a medical reason for delivering the baby earlier than this. For example, if you’re expecting more than 1 baby.
What is an emergency c-section?
You may have an unplanned emergency c-section if your baby needs to be delivered quickly. This may happen if your labour is not progressing or there’s any concern about your or your baby’s wellbeing.
The word ‘emergency’ makes it sound rushed, but there’s often time to decide whether you want a c-section. Your doctor and midwife will explain what your options are. If your or your baby’s health is at risk, you may need to have a c-section more quickly.
"Everything I had ever heard about c-sections had been negative and scary. So, when I was told I needed an emergency c-section, I was very anxious. But it went well and I had a good experience, which I hadn’t thought was possible."
There’s no strong evidence that any of these things affect your chances of needing a c-section:
- walking around during labour
- not lying on your back during labour
- being in water during labour
- drinking raspberry leaf tea
- the midwife or doctor breaking your waters early
- having an epidural.
There is no evidence that your height or the size of your baby can predict whether you will need a c-section. Being short or having a small pelvis or small feet does not affect whether you can have a vaginal birth. But you may be more likely to have a c-section if you’re overweight or over the age of 40.
You may be less likely to have a c-section if you:
- give birth in a midwife-led unit, or
- have continuous support during labour from a midwife or someone trained to support you, such as a doula.
Read about what happens during a c-section.
Read about preparing for a c-section.
- BHIVA (2018). BHIVA guidelines for the management of HIV in pregnancy and postpartum 2018 (2020 third interim update). British HIV Association www.bhiva.org/pregnancy-guidelines
- Bohren MA et al (2017). Continuous support for women during childbirth. Cochrane Database of Systematic Reviews 2017, Issue 7. Art. No.: CD003766.
- NHS England (2020). Better Births Four Years On: A review of progress. NHS England and NHS Improvement www.england.nhs.uk/publication/better-births-four-years-on-a-review-of-progress/
- NICE (2014, updated 2017). Intrapartum care for healthy women and babies: Clinical guideline 190. National Institute for health and care excellence www.nice.org.uk/guidance/cg190
- NICE (2019). Twin and triplet pregnancy: NICE guideline 137. National Institute for health and care excellence www.nice.org.uk/guidance/ng137
- NICE (2021). Caesarean birth: NICE guideline 192. National Institute for health and care excellence www.nice.org.uk/guidance/ng192
- Royal College of Obstetricians and Gynaecologists (2014) Management of Genital Herpes in Pregnancy. London Royal College of Obstetricians and Gynaecologists. www.rcog.org.uk/en/guidelines-research-services/guidelines/genital-herpes/
- Royal College of Obstetricians and Gynaecologists (2015) Birth after Previous Caesarean Birth (Green-top Guideline No. 45). London Royal College of Obstetricians and Gynaecologists. www.rcog.org.uk/en/guidelines-research-services/guidelines/gtg45/