C-sections - everything you need to know

What is a c -section? What are elective versus emergency c-sections and who decides if you need one? Find out everything you need to know here.

A caesarean section (c-section) is an operation where a doctor makes a cut in your abdomen (above your bikini line) and womb and lifts your baby out through it.

If you know you will need a c-section before you go into labour, this is called a planned (elective) c-section.

If you and your healthcare team decide at short notice that a c-section is the safest way to deliver your baby, it is called an emergency c-section.

About one in four women who give birth in the UK have a c-section. Most of these are emergency c-sections.

Planned c-section

Planned c-sections are usually done from week 39 of pregnancy because babies born earlier than this may not be fully developed for life outside the womb. You may have your c-section earlier than this if there’s a medical reason for delivering the baby sooner, for example, if you’re expecting more than one baby.

If you need a planned c-section, you will see an obstetrician (a doctor who specialises in women’s care during pregnancy, labour and after birth). You will also see a midwife at each of your maternity appointments. The midwife or obstetrician will explain why they advise you to have a c-section. Possible reasons include:

  • problems with the placenta, such as a low-lying placenta (placenta praevia)
  • the baby is lying in a difficult position for labour, such as bottom down (breech)
  • you are expecting twins – for example, if the babies share a placenta or if either baby is lying in a difficult position for labour
  • you are expecting more than two babies.

Some women with HIV or genital herpes may be offered a c-section in some cases to prevent passing the virus to the baby.

The obstetrician will explain the benefits and risks of a c-section and your other birth options. It is your decision; you don’t have to have a c-section if you don’t want one.

Can I choose to have a planned c-section?

You may feel you want to have a c-section, even if you don’t need one for medical reasons. For example, you may feel you can’t cope with the pain involved with a vaginal birth. Or if you had a difficult vaginal delivery with your last baby, you may be worried about going through the same thing again.

But having a c-section is not risk-free. It is major abdominal surgery, which carries some risks for you and your baby. It is likely to take you longer to recover from the birth and you are likely to have some pain and discomfort for a few weeks afterwards.

Talk to your midwife about anything that is worrying you and about the reasons why you would like a c-section. They may be able to put your mind at rest. You can ask to see an obstetrician or anaesthetist to find out more about what having a c-section will involve.

Some women want a vaginal birth but are worried that they won’t be able to cope. If you feel this way, speak to your midwife as soon as you can. They may refer you to a specialist, who can offer you any emotional support you may need and give you more information about your options. This can help you make an informed decision about how you want to deliver your baby.

If you’re still sure you want a c-section after talking it through with your healthcare team, you should be able to have one. Some women may feel guilty or worried about asking for a c-section when they don’t have a medical need for one. But your healthcare team will not judge you and will want to help you have the best possible birth experience. If you feel your obstetrician doesn’t support your choice of birth, you can ask to see a different doctor. Some hospitals aren’t able to get funding for c-sections without a medical need. If this happens, you can ask to move to a hospital in a different area.

‘I asked for a c-section because I had a difficult first birth followed by postnatal depression and post-traumatic stress. The team looking after me reassured me throughout my pregnancy but reminded me of my other birth options. They helped with my birth plan, which included different options, including a planned c section, trying a vaginal birth and what would happen if I went into labour early. Having this reassurance reduced my anxiety and helped me feel confident about what I wanted for the birth.’ Laura

Emergency c-section

If your c-section has not been planned, it is called an emergency c-section. The word ‘emergency’ makes it sound last minute and rushed, but this is simply the medical term. It is often not an emergency and doesn’t in itself mean that you or your baby are in danger.

Possible reasons for having an emergency c-section include:

  • your labour isn’t progressing
  • you don’t go into labour after an induction and you are past your due date
  • you have vaginal bleeding during pregnancy or labour
  • there are concerns about your, or your baby’s, health
  • you go into labour before a planned c-section.

‘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.’ Facebook user

C-section myths

There is no strong evidence that the following actions 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.

There is no evidence that your height, or the size of your baby, can predict whether you will need a c-section. If you are short or you have a small pelvis or small feet, this doesn’t mean you can’t have a vaginal birth.

If there are no other complications, expecting a large baby doesn’t mean you will need a c-section.  

Read about what happens during a c-section here

Read about preparing for a c-section here

Sources

  1. Glavind J, Uldbjerg N (2015) Elective cesarean delivery at 38 and 39 weeks: neonatal and maternal risks. Curr Opin Obstet Gynecol 27: 121–127.
  2. Hofmeyr GJ, Hannah M, Lawrie TA (2015) Planned caesarean section for term breech delivery. Cochrane Database of Systematic Reviews 2015, Issue 7. Art. No.: CD000166. DOI: 10.1002/14651858.CD000166.pub2.
  3. NICE (2013) Caesarean section. Quality standard 32, National Institute for Health and Care Excellence.
  4. NICE (2011) Caesarean section. Clinical guideline 132, London National Institute for Health and Clinical Excellence.
  5. Royal College of Obstetricians and Gynaecologists (2015) Birth after Previous Caesarean Birth (Green-top Guideline No. 45). London Royal College of Obstetricians and Gynaecologists.
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Last reviewed on April 1st, 2015. Next review date April 1st, 2018.

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Comments

  • By Anonymous (not verified) on 21 Apr 2016 - 10:03

    Thank you for all this excellent information on labour and birth.

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