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Health & Pregnancy

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Cesarean Section - Why It Is Done

Some cesarean deliveries are planned ahead of time. Others are done when a quick delivery is needed to ensure the mother's and infant's well-being.

Planned cesarean

Some cesarean sections are planned when a known medical problem would make labor dangerous for the mother or baby. Medical reasons for a planned cesarean may include:

  • A fetus in any position that is not head-down (including breech position). For more information, see the topic Breech Position and Breech Birth.
  • Decreased blood supply to the placenta before birth, which may lead to a small baby.
  • Estimated fetal size of over 9 lb (4.1 kg) to 10 lb (4.5 kg) or more.
  • A maternal disease or condition that may be made worse by the stress of labor. One example is heart disease.
  • A known health problem with the baby, such as spina bifida.
  • A placenta that is blocking the cervix (placenta previa). For more information, see the topic Placenta Previa.
  • Open sores from active genital herpes near the due date, which can be passed to the fetus during vaginal delivery.
  • Infection with human immunodeficiency virus (HIV), which can be passed to the fetus during vaginal delivery.2
  • Multiple pregnancy. The direction and size of the incision depends on the position of the fetuses. In particular, cesarean delivery may be needed for multiple births involving:
    • Twins that share one amniotic sac (monoamniotic twins), because of the risk that the cords will get tangled.
    • Three fetuses or more.
    • Twins that are joined by any part of the body (conjoined).
    • An overstretched uterus that cannot contract adequately during labor (uterine inertia), making labor prolonged and difficult.
    • Poorly positioned or large fetuses.

Many cesarean deliveries are planned ahead of time for women who have had a cesarean in the past. Medical reasons for a planned repeat cesarean may include:

  • A current problem that has led to difficult labor and cesarean before, such as a narrow pelvis and a large fetus (cephalopelvic disproportion).
  • Factors that increase the risk of uterine rupture during labor, such as having a vertical scar, triplets or more, or a very large fetus thought to weigh 9 lb (4.1 kg) to 10 lb (4.5 kg) or more. For more information, see the topic Vaginal Birth After Cesarean (VBAC).
  • No access to constant medical supervision by a cesarean-trained doctor during active labor, or no available facilities for an emergency cesarean.
Pregnancy: Should I Try Vaginal Birth After a Past C-Section (VBAC)?

Some women request to have a C-section even though there is no medical need for it. Experts don't agree on whether C-sections should be done when there is no medical reason. Most mothers and babies do well after C-section. But it's major surgery, and major surgery has some risks.

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