Childbirth: Reasons for Cesarean Delivery - Topic Overview
A baby can be born in one of two ways. A vaginal birth is one in
which the baby is delivered through the mother's birth canal (vagina). A
cesarean birth (C-section) is one in which the baby is delivered through an
incision in the mother's lower abdomen and uterus. A cesarean birth is a
surgical procedure done with
anesthesia. It can take 4 to 6 weeks to recover
completely from the surgery. But most mothers are up and able to care for
their infants in 3 to 4 days.
A C-section may be done when a quick delivery is needed for the
safety of the mother or baby. Some cesareans are done after labor has
slowed or stopped and a manual exam shows that the fetal head is not engaging
in the pelvis. This sometimes happens when the fetal head is larger than the
mother's pelvic girdle (cephalopelvic disproportion).
Some conditions or problems that may require a cesarean birth can be
identified before labor begins. These conditions include the following:
- The baby's feet or buttocks are positioned toward
the cervix (breech position).
- The placenta is blocking the
cervix (placenta previa).
- The mother has
open sores caused by
genital herpes when labor begins. Herpes can be passed
to the fetus during delivery and cause serious problems.
- The mother
has a disease or condition that may be made worse by the stress of
- The baby is firmly estimated to be over
5000 g (11 lb), or over
4500 g (10 lb) for a mother
who has diabetes.1
- The blood supply to the
placenta is decreased before birth, most often because
the mother develops high blood pressure during pregnancy, or
preeclampsia. (Usually, the doctor or nurse-midwife
tries to induce labor first.)
- The fetus is 2 or more weeks overdue
(postmature). When pregnancy lasts past 42 weeks, the aging placenta may not
provide enough oxygen and nutrients to the fetus. Usually, the doctor first
tries to induce labor. If induction does not work, a cesarean birth is
Many cesarean births are done on an emergency basis when maternal or
fetal problems or complications develop during labor. Such situations
- Fetal distress (suggested by a very rapid or very
slow heart rate).
- Difficult, slow labor
- Labor that has stopped completely (failure to
- Cephalopelvic disproportion, a combination of a large
fetal head and a mother's narrower pelvic structure. This condition is often
linked to failure to progress, or dystocia.
- Placenta abruptio, which can cause excessive bleeding (hemorrhage) and decreased
oxygen supply to the baby.
- Umbilical cord
problems. Examples include:
- Cord prolapse, when the cord has slipped into
the birth canal ahead of the baby. When the baby moves into the birth canal and
presses against the cord, the blood (and oxygen) supply can be cut
- When the cord is torn during delivery, decreasing the baby's
In the past, a woman who had one cesarean birth then had to have all
of her other babies delivered by cesarean also. This is no longer the case.
Depending on the reason for the original cesarean and the type of incision that
was made, a woman may be able to deliver her next baby vaginally. For more
information, see the topic Vaginal Birth After Cesarean (VBAC).