By Dr Ananya Mandal, MD
A Cesarean section is a form of abdominal surgery that is performed to deliver a baby via an incision made in the abdomen.
When is a Cesarean section needed?
A Cesarean section (C-section) may be planned in cases where it becomes evident during pregnancy that the procedure will be necessary or it may be performed as an emergency intervention.
Some examples of the circumstances where a C-section is needed include:
Non-progress of labour
Prolonged labour is the most common reason for a C-section. The labour may be prolonged because the cervix is not dilating sufficiently despite contractions or because the baby’s head is simply too big to pass through the birth canal.
If the baby is not receiving enough oxygen or the heart rate is increasing, a C-section may be recommended.
Abnormal position of the baby
For a vaginal birth, the baby is usually positioned head-down in the womb and the head comes out before the rest of the baby’s body. If the baby’s buttocks have moved into the birth canal first (breech position) or the baby is positioned on its side (transverse position), a C-section may be advised.
Health concern in the mother
A medical condition such as unstable heart disease or high blood pressure can make labor dangerous. A C-section may also be recommended in cases where the mother is known to have an infection they could pass onto their baby during delivery, such as HIV.
Procedure and types
The most common type of C-section performed is the lower uterine segment C-section (LUSCS), which involves a transverse incision being made across the lower abdomen, just above the bladder.
A less common form of C-section involves a vertical incision being made in the abdomen, which allows a larger space for delivering the baby. However, this procedure is associated with more blood loss and a greater complication rate than LUSCS and is rarely used today.
In most cases, regional anesthesia is administered for a C-section. Epidural anesthesia numbs pain from the waist down. In rare cases, general anesthesia may be used.
Risks associated with a C-section
Although C-section is a common procedure, it is still associated with a certain degree of risk. Some of the main risks of C-section include:
- Bleeding during surgery
- Infection of the incision wound
- Infection of the womb lining
- Damage to surrounding structures such as the bladder or bowel
- Thrombosis in the leg that may break off and lodge in the lung
Reviewed by Sally Robertson, BSc
Last Updated: Oct 8, 2014