A caesarean section (c-section) can be the safest option if there are concerns about your, or your baby’s, health. But there are benefits and risks to having a c-section. Speak to your midwife or doctor about how these may affect you.
What are the benefits of a c-section?
For women who have not had a c-section before, a planned c-section might reduce the risk of:
- pain during and after the birth
- injury to the vagina
- heavy bleeding after the birth
- loss of bladder control
- the womb, vagina, bowel or bladder pushing against the wall of the vagina (pelvic organ prolapse).
This doesn’t mean that these things won’t happen, but your risk is lower than if you had a vaginal birth.
Your risk of pain during sex and bowel problems is no higher than for a vaginal birth.
Risks of having a c-section
Having a c-section can increase some risks to you and your baby. This doesn’t mean that these things will happen to you, but there may be a higher chance of them happening than if you had a vaginal birth. Speak to your midwife or doctor about how these risks may affect you and your baby.
Possible c-section risks to you include:
- infection of your wound or the lining of the womb
- bleeding that leads to a blood transfusion or having the womb removed – this is uncommon and may be more likely if you had problems with the placenta or bleeding during pregnancy
- heart attack
- problems getting pregnant in the future
- problems in future pregnancies, such as low-lying placenta, placenta accreta, miscarriage and stillbirth
Caesarean sections performed late in labour have been linked to a risk of preterm birth in the next pregnancy. When done at full dilatation (in the second stage of labour) the risk is increased from 2% to around 15%.
Possible c-section risks to your baby include:
- a cut to the skin, caused during surgery – this is usually minor and heals quickly
- a higher risk of admission to the neonatal unit
- breathing problems – this is more common if your baby is born before 39 weeks of pregnancy. Most breathing problems get better after a few days but some babies need to go into the neonatal unit. Speak to your midwife if you are worried about your baby’s breathing while you are in hospital. If you are at home and your baby isn’t breathing properly, call 999.
C-sections and links to long-term conditions
There is limited research into how c-sections affect the long-term health of children. There is some evidence that children born by c-section may have a higher risk of long-term conditions, such as childhood asthma, type 1 diabetes or obesity. The reason for this increased risk isn’t clear. There isn’t enough evidence to show that it is caused by the c-section itself. For example the health of the mother and the reason for having a c-section could equally be the cause of the child’s risk of long-term conditions.
One theory however is that the baby isn’t exposed to bacteria in the mother’s vagina. This bacteria is called the microbiome, and it is found in the guts of babies who have been born vaginally and may help protect against asthma and obesity during childhood.
It could also be linked to the fact that women who have a c-section are more likely to have problems with establishing breastfeeding, which protects against obesity in the baby.
C-section and future pregnancies
For women who have had up to four previous c-sections, the risks linked to having another c-section compared with the risks of a vaginal birth for following pregnancies is the same. There is a slightly higher risk of the scar from a previous c-section tearing during a vaginal birth (uterine rupture), but this is rare.
Even if you have had a previous caesarean, you may be able to have a vaginal birth for your next baby if you want one. This is called vaginal birth after caesarean (VBAC). You may need to give birth in a hospital where you can have an emergency c-section if you need one.
If your labour needs to be induced for any reason, you can choose whether to go ahead with induction or have a planned c-section. There are benefits and risks with both options so you should discuss your personal situation with your healthcare team.
While you are still in hospital, your midwife should give you written information on your birth options for future pregnancies.
What should I expect after a c-section?
It usually takes longer to recover from a c-section than from a vaginal birth. After your operation you may:
- find it painful or uncomfortable to move around
- find it more physically difficult to look after your baby
- take longer to start exercising or be active after the birth
- find it harder to establish breastfeeding – for example, if you have pain or can’t move around easily
- have an increased risk of blood clots – your midwife may give you blood-thinning drugs and compression stockings, and encourage you to get up and move around, and drink plenty of fluids to reduce your risk
- have vaginal bleeding (lochia) for two to six weeks – this is the same as after a vaginal delivery
- have trapped wind, which can be painful – peppermint tea may help with this
- feel a range of emotions – such as sadness or disappointment if you hadn’t planned to have a c-section. There may be a link between having a c-section and postnatal depression.
You will stay in bed for several hours after your operation, until the anaesthetic has worn off. During this time, you will need help from other people to pass your baby to you.
Having a c-section usually involves a longer hospital stay. Women who have had an uncomplicated vaginal delivery may be able to go home after a few hours. After a c-section, you may need to stay in hospital for between two and four days, although you can usually go home sooner if there are no complications and you have support at home.
It can take about six weeks to recover from a c-section. While you’re recovering at home, wait until you feel ready and you don’t have any pain before carrying anything heavy, driving, having sex or exercising heavily. Gentle exercise, like walking, will help you recover.
Charley, 35, from Edinburgh was amazed when she found out she was pregnant in 2018. She’d been warned that pregnancy might be difficult for her as, a few years before, she’d had 3 procedures to remove abnormal cells from her cervix. After a worrying bleed at 10 weeks, Charley was referred to Tommy’s Lothian Preterm Birth Clinic at the Royal Infirmary of Edinburgh. With access to specialist care and monitoring, Charley’s pregnancy progressed, and baby Tommy was born in May 2019.
"I spent a couple of weeks at home taking it very easy. Even a sneeze or a cough could be painful, so I didn’t do much other than take a few steps around the flat when I could."
'I wish there was more I could say about that but it really was over so quickly!'
Learn about the emotions you may experience after your c-section and how to cope with them, including depression and PTSD if it was an emergency c-section. Find out where you can get support.
Find out how long you should wait before exercising and the activities that are safe to do while recovering. Learn how pelvic floor and abdominal exercises can help.
Learn how being overweight can affect your chances of needing a c-section and how this affects your recovery afterwards.
Find out how you can help your partner recover after having a c-section, including tips from other dads.
Find out what you can do to establish breastfeeding after a c-section, including positions to make breastfeeding more comfortable
Advice on how to make a healthy recovery at home after a c-section. Find out how long it takes to recover and how to care for your wound.
It is common to have some bleeding after a caesarean section. Find out how long you are likely to bleed for and how heavy it should be.
Find out what to expect when you’re in hospital after a c-section, including side effects, pain relief and when you can go home.
Find out what will happen during your c-section. Learn about the preparation, anaesthetic and what goes on during the procedure itself.
- Azam S et al. (2014) Planned caesarean section or trial of vaginal delivery? A meta-analysis. Curr Opin Obstet Gynecol 26:461–468.
- Beake S et al. (2017) Interventions for women who have a caesarean birth to increase uptake and duration of breastfeeding: a systematic review. Matern Child Nutr 13(4): e12390.
- Blustein J, Liu J (2015) Time to consider the risks of caesarean delivery for long term child health. BMJ350: h2410.
- Dodd JM et al. (2017) Elective repeat caesarean section versus induction of labour for women with a previous caesarean birth. Cochrane Database of Systematic Reviews Issue 7. Art. No.: CD004906. DOI: 10.1002/14651858.
- Keag OE, Norman JE, Stock SJ (2018) Long-term risks and benefits associated with cesarean delivery for mother, baby, and subsequent pregnancies: Systematic review and meta-analysis. PLoS Med 15(1): e1002494.
- Kealy, M. A., Small, R. E., & Liamputtong, P. (2010). Recovery after caesarean birth: a qualitative study of women’s accounts in Victoria, Australia. BMC Pregnancy and Childbirth, 10, 47. http://doi.org/10.1186/1471-2393-10-47
- Li H-t, Zhou Y-b, Liu J-m (2013) The impact of cesarean section on offspring overweight and obesity: a systematic review and meta-analysis. International Journal of Obesity 37: 893–899.
- NHS Choices (2016) [Accessed 15 March 2018] Caesarean section: recovery. www.nhs.uk/conditions/caesarean-section/recovery/
- NHS Choices (2016) [Accessed 25 January 2018] Caesarean section: risks. www.nhs.uk/conditions/caesarean-section/risks/
- NICE (2013) Caesarean section. Quality standard 32, National Institute for Health and Care Excellence.
- NICE (2011) Caesarean section. Clinical guideline 132, London National Institute for Health and Clinical Excellence.
- Royal College of Obstetricians and Gynaecologists (2015) [Accessed 25 January 2018] Birth after Previous Caesarean Birth (Green-top Guideline No. 45) www.rcog.org.uk/globalassets/documents/guidelines/gtg_45.pdf
- Xu H et al. (2017) Cesarean section and risk of postpartum depression: A meta-analysis. Journal of Psychosomatic Research 97: 118 – 126.
- Wood, S., Tang, S., and Crawford, S. Cesarean delivery in the second stage of labor and the risk of subsequent premature birth. Am J Obstet Gynecol. 2017; 217: 63.e1–63.e10
- Berghella, V., Gimovsky, A.C., Levine, L.D., and Vink, J. Cesarean in the second stage: a possible risk factor for subsequent spontaneous preterm birth. Am J Obstet Gynecol. 2017; 217: 1–3
- Hall, M., Vousden, N., Carter, J., Hezelgrave, N., and Shennan, A.H. Prevention of mid-trimester loss following full dilatation caesarean section: a potential role for transabdominal cervical cerclage.J Obstet Gynaecol. 2015; 35: 98–99
- Watson, H.A., Carter, J., David, A.L., Seed, P.T., and Shennan, A.H. Full dilation cesarean section: a risk factor for recurrent second-trimester loss and preterm birth. Acta Obstetr Gynecol Scand. 2017; 96: 1100–110
ℹLast reviewed on April 24th, 2018. Next review date April 24th, 2021.
By Daniel (not verified) on 9 Jan 2020 - 09:22
My wife gave birth beautiful baby girl via c-section and experienced pain in the abdomen and she is in ICU fighting for her life because of the small bowel injury