Introduction

A caesarean section,or C-section,is an operation to deliveryour baby through a cut made in your tummy and womb.

The cut is usually made across your tummy, just below your bikini line.

A caesarean is a major operation that carries a number of risks, so it's usually only done if it's the safest option for you and your baby.

Aroundone in everyfour tofive pregnant women in the UK has a caesarean.

This page covers:

Why they're carried out

Asking for one

What happens

Recovery

Risks and complications

Future pregnancies

Why caesareans arecarried out

A caesarean may berecommended as a planned (elective) procedure or donein an emergencyif it's thought a vaginal birth is too risky. They're usually performed after the 38th week of pregnancy.

Acaesarean may be carried out because:

• your baby is in the breech position (feet first)and your doctor has been unable to turn them by applying gentle pressure to your tummy, or you would prefer they didn't try this
• you have a low-lying placenta (placenta praevia)
• you havepregnancy-related high blood pressure (pre-eclampsia)
• you have certain infections, such as a first genital herpes infection occurring late in pregnancy or untreated HIV
• your baby isn't getting enough oxygen and nutrients sometimes this may mean the baby needs to be delivered immediately
• your labour isn't progressing or there's excessivevaginal bleeding

If there's time to plan the procedure, your midwife or doctor will discuss the benefits and risks of a caesarean compared with a vaginal birth.

Asking for a caesarean

Some women choose to have acaesarean for non-medical reasons. If you ask your midwife or doctor for a caesarean when there aren't medical reasons, theywill explain the overall benefits and risks of a caesarean compared with a vaginal birth.

If you're anxious about giving birth,you should be offered the chance to discuss your anxiety with a healthcare professional who can offer support during your pregnancy and labour.

If after discussion and support you still feel that a vaginal birth isn't an acceptable option, you're entitled to have a planned caesarean.

What happens during a caesarean

Most caesareans arecarried out under spinal or epidural anaesthetic . This mean you'll be awake, but the lower part of your body is numbed so you won't feel any pain.

During the procedure:

• ascreen is placed across your body so you can't see what's being done the doctors and nurses will let you know what's happening
• acut about10-20cm long will usually be made across your lower tummy and womb so your baby can be delivered
• you may feel sometugging and pulling during the procedure
• you and you birth partner will be able to see and hold your baby as soon as they've been delivered

The whole operation normally takes about 40-50 minutes.

Occasionally a general anaesthetic , where you're asleep, may be used, particularly if the baby needs to be delivered more quickly.

You might need to stay in hospital for three or four days, comparedwith one or two days for a vaginal birth.

You may experience some discomfort in your tummy for the first few days, and you'll beoffered painkillers to help with this.

When you go home, you'll need to take things easy at first. You may need to avoid some activities suchas driving for six weeks or so.

The wound in your tummy will eventually form a scar . This may be red and obvious at first, but it should fade with time andwill often be hidden in your pubic hair.

Risks of a caesarean

A caesarean is generally a very safe procedure, but like any type of surgery itcarries a certain amount of risk.

It's important to be aware of the possible complications, particularly if you're considering having a caesarean for non-medical reasons.

Possible complications include:

• infection of the wound or womb lining
• blood clots
• excessive bleeding
• damage to nearby areas, such as the bladder or the tubes that connect the kidneys and bladder (ureter)
• temporary breathing difficulties in your baby
• accidentally cutting your baby when your womb is opened

However,you may need some extra monitoring during labour just to make sure everything is progressing well.

Some women may be advised to have another caesarean if they have another baby. This depends on whether a caesarean is still the safest option for them and their baby.

For more information, the Royal College of Obstetricians and Gynaecologists has a leaflet on birth optionsafter previous caesarean section(PDF, 357kb) .

Abdomen

The abdomen is the part of the body between the chest and the hips.