A caesarean birth, also known as a caesarean section, may be recommended by your doctor as the safest option for you and your baby. Understand the risks and benefits of planned and unplanned caesareans.
What is a c-section?
A caesarean section is an operation to allow your baby to be born without going through the birth canal. Instead, your baby is born through a cut in your abdomen.
A caesarean birth can usually be done with a type of regional anaesthetic such as an epidural which allows you to remain awake if you want.
Because it is a form of intervention that involves major abdominal surgery, recovery after a c-section generally takes longer than after a vaginal birth.
Why might I have a caesarean?
There are two kinds of c-sections: unplanned and planned.
Also called an emergency caesarean, this is a c-section delivery that happens after you have gone into labour.
Although it sounds alarming, not all unplanned c-sections have to happen quickly. For example, you may have a c-section if you are in labour for a long time but you don’t seem to be getting closer to giving birth. In this case, it may be hours between you and the consultant agreeing to do a caesarean section, and you going into surgery.
In other circumstances, the c-section needs to take place as soon as possible because an unexpected problem has arisen and your baby needs to be born urgently. If this happens, you’ll probably go into surgery within half an hour of the decision being made.
It’s worth thinking about what you’d like to happen if you do end up having a c-section. Discuss it with your midwife in advance and include this information when you’re writing your birth plan.
“I was induced at 12 days overdue, but after several days I’d only reached six cm dilation and was whisked down the corridor for an emergency c-section. My healthy baby boy was born just fine though and I made a speedy recovery so all was well.”
Also known as an elective caesarean section, this is a c-section scheduled to take place before labour starts. You’ll probably know the date of the surgery in advance and it often takes place when you’re around 39 weeks pregnant.
Elective sections can be planned for medical reasons, for example if your placenta covers your cervix so your baby wouldn’t be able to be born vaginally. Although it’s called elective, there is in reality little choice involved in this type of scenario.
There are other cases where the choice to have a planned c-section is a decision for you to make with your consultant. For example, many hospitals recommend that you give birth by a planned c-section if your baby is breech, as they feel that’s the safest way for your baby to be born, but you can still choose to have a vaginal delivery.
“I had a planned c-section because I was at risk of heart complications. The birth was a positive experience and I recovered fine. I really don’t like the term ‘elective c-section’ though – my decision was based on what I believed would be best medically, not to avoid a vaginal delivery.”
Can I ask to have a caesarean?
Yes, some elective c-sections are performed without there being a medical reason. Often, this is requested by women who have birth anxiety, perhaps because of a previous traumatic birth, or who have suffered sexual abuse in the past.
If you are considering requesting a planned caesarean birth, you can ask your midwife or doctor and they’ll explain the risks and benefits of you having a caesarean compared to a vaginal birth.
If you’re anxious about having a vaginal birth, you should be offered a referral to a health professional who can help you cope with your anxiety. If, after discussion and any support offered, you decide that you would like to have a caesarean then you should be offered a planned c-section. If your doctor isn’t willing to perform the caesarean, they should refer you to a doctor who will be.
If you’ve been planning a vaginal birth you may decide during labour that you would like to have a caesarean. At this point, you’re not entitled to a caesarean unless the doctor decides that there’s a medical need. Therefore the doctor will consider your views and make a decision using their clinical judgement.
“Every woman deserves to be able to choose how to give birth. I had an elective c-section out of choice without any underlying health reasons. It was an amazing experience – my baby was born healthy and I recovered quickly. I’m planning to give birth to my next baby the same way.”
How many women have a c-section?
A 2017 survey by the Care Quality Commission found that 15% of women who gave birth in January 2017 had an emergency c-section, and 11% had a planned c-section.
NHS maternity statistics show that the chances of having an unplanned caesarean differ between different groups of women:
- Older women are more likely to have an unplanned caesarean than younger women.
- First-time mothers are more likely to have an unplanned caesarean than women giving birth for the second or subsequent time.
Use our Birth Choice tool to see the rates of planned and unplanned caesareans at your local hospitals.
What are the risks of a caesarean birth?
Having a caesarean is generally very safe. However, with any operation there are risks involved.
- The c-section recovery period is generally longer than that after a vaginal birth.
- You may contract an infection in the scar or the lining of your uterus following the operation.
- Your chances of developing a blood clot are increased.
- You may experience anaesthetic complications, as with any operation.
- Scar tissue called adhesions can form in bands between the organs in your abdomen, which can be painful and result in the need for further operations.
We’ve also put together a c-section hospital bag checklist which you can download to help you get ready for an elective caesarean, to make sure you bring everything that can come in handy during and after the birth.
More from Which?
- C-section hospital bag checklist: Use our guide to what to put in your bag ahead of an elective c-section to make you as comfortable as possible during and after the birth.
- Read our advice on NHS and private ultrasound scans with information on when they take place and what to expect
- Tips for getting started with breastfeeding: what to expect from your baby’s first feed after birth
These are the sources of information used in this article:
Health and Social Care Information Centre, Hospital Maternity Activity 2015-16, NHS
Care Quality Commission, Maternity Services Survey 2017 (2017)