Childbirth: Is Planning a C-Section a Good Choice?

Topic Overview

In the past 40 years, the rate of cesarean (C-section) deliveries has jumped from about 1 out of 20 births to about 1 out of 3 births.^{footnote 1} This trend has caused experts to worry that C-sections are being done more often than needed.

Because of the risks of C-section, the American College of Obstetricians and Gynecologists recommends that planned C-sections generally be done only for medical reasons. It also recommends that if a C-section is planned, it should be done at 39 weeks or later in the pregnancy.

But some women and their partners have personal reasons for wanting to schedule their baby's birth.

If you're thinking of having a C-section for personal reasons, it's important to weigh what you want against the risks. You may want to talk to your doctor about reasons for and against a planned C-section.

What is a C-section?

A C-section is the delivery of a baby through a cut (incision) in the mother's belly and uterus.

Most C-sections are unplanned. They are done because of problems that occur during labor. These problems might include:

• Labor that slows or stops.
• High blood pressure or other problems for the mother.
• Signs of distress in the baby. These signs may include a very fast or slow heart rate.

What are the risks of a C-section?

Although most mothers and babies do well after C-section, it is major surgery. It has more risks than a vaginal delivery. The risks of C-section include:

• Infection of the incision or the uterus.
• Heavy blood loss.
• Injury to the mother or baby.
• Problems from the anesthesia. These may include nausea, vomiting, and a bad headache.
• Breathing problems in the baby if he or she was delivered before the due date.
• A longer hospital stay than after a vaginal birth.
• Risks for a future pregnancy. A woman who has had a C-section has a small risk of the scar tearing open during labor if she has a vaginal birth. She also has a slightly higher risk of a problem with the placenta, such as placenta previa.

Why might a C-section be planned for medical reasons?

In some cases, a planned C-section may be safer than a vaginal delivery. This may be the case if:

• The mother has a health problem, such as a heart condition.
• The baby isn't in a head-down position for delivery. The is called a breech position.
• The uterus has scars from past surgeries. This could increase the chance of a tear in the uterus.
• The mother has an infection, such as genital herpes, that could be spread to the baby.
• The mother is having twins or more.
• The baby weighs 9 to 10 pounds or more.

Why would a C-section be planned for personal reasons?

Some women have personal reasons for wanting a C-section.

• They may worry that their pain won't be controlled.
• They may be concerned that labor will cause pelvic floor problems, such as incontinence.
• Their partner may be away at the due date (such as on a military deployment), so they want to have the baby sooner.
• They want to attend an important family event (such as a reunion).
• They want to be sure that their own doctor delivers the baby, rather than an on-call doctor. (In some cases, the doctor may suggest a C-section because of his or her schedule.)
• They may feel shy or embarrassed about people seeing them giving birth.

Talk to your doctor about your concerns

It's important to talk openly and honestly with your doctor about your wishes and concerns.

In some cases, your doctor may be able to help you feel more confident about vaginal birth. For example, your doctor could discuss the many ways to control pain during labor. Or he or she may explain how often pelvic floor problems happen and what can be done to prevent them. These discussions may change your mind about planning a C-section.