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Health & Pregnancy

What to Expect if You Have a Cesarean Delivery

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WebMD Feature

A cesarean section involves delivering a baby through an incision in a woman's abdomen and uterus. Approximately 15% to 20% of U.S. babies are born by cesarean section -- a significant increase from the 3% to 5% rate of 25 years ago. Although the media like to put a negative spin on this increase by focusing on the number of unnecessary cesareans, what often gets left out of the discussion is the number of babies whose lives have been saved or improved because of this increase in the cesarean rate.

This isn't to say that the 25% or higher cesarean rate at some institutions is something to cheer about, however. Cesareans continue to be four times riskier than vaginal deliveries (at least according to oft-quoted studies; in some patient populations, however, the difference in risk appears to be significantly smaller). Potential complications include

  • infections (particularly of the uterus, the nearby pelvic organs, and the incision)
  • excessive blood loss
  • complications from the anesthesia
  • blood clots due to decreased mobility after surgery
  • bowel and bladder injuries

You may have heard a common myth about cesareans: that the baby misses out on the squeezing motion of a vaginal delivery -- a process that helps clear amniotic fluid from the lungs and stimulate the circulation. There's no evidence showing that babies delivered through cesarean section are at a disadvantage because of this so-called lack of squeezing. In truth, a fair bit of squeezing does occur as the doctor guides your baby out through the incision he or she has made in your uterus.

Still, most caregivers agree that cesareans should be planned only when there's a solid medical reason for avoiding a vaginal delivery. Here are some common reasons:

  • The baby is predicted to be too large to pass through your pelvis.
  • The baby is in a breech or transverse position.
  • You have placenta previa.
  • You have an active genital herpes infection.
  • You have previously had a cesarean section.

Note: Not all women who have previously had a cesarean section are candidates for a repeat cesarean. The cause of your previous cesarean (for example, a one-time emergency versus a chronic problem), the type of uterine incision used, and your obstetrical status during your subsequent pregnancy will determine whether another cesarean will be necessary. We'll be discussing this issue further on in this chapter.

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