Medical reasons for a c-section

What is a c-section?

A c-section (short for cesarean birth) is surgery in which your baby is born through a cut that your doctor makes in your belly and uterus. For some women and babies, a c-section is safer than vaginal birth. If you have medical conditions that affect your pregnancy, you may need a c-section to protect the health of your baby.

A c-section may be planned (also called scheduled). This means you and your health care provider decide when to schedule the c-section based on your health condition and the condition of your baby. Or a c-section may be an emergency. An emergency c-section has to be done immediately because your health or your baby’s health is in danger.

If there are medical reasons to schedule your c-section, talk to your provider about waiting until at least 39 weeks of pregnancy. This gives your baby the time she needs to grow and develop before birth. Scheduling a c-section should be for medical reasons only.

What are medical reasons for a c-section?

You may need a c-section because of complications that make vaginal birth unsafe for you or your baby. For example:

Complications during pregnancy

• You’ve had a c-section in the past or you’ve had other surgeries on your uterus (womb). The more c-sections you have, the greater your risk for pregnancy complications. Some women can safely have a vaginal birth after they’ve had a c-section. This is called a VBAC. If you’ve had a c-section in the past, talk to your provider to see if VBAC may be possible in your next pregnancy.
• There are problems with the placenta, such as placenta previa, which can cause dangerous bleeding during vaginal birth. The placenta grows in your uterus and supplies the baby with food and oxygen through the umbilical cord.
• You have an infection, like HIV or genital herpes. You can pass these infections to your baby during vaginal birth. So a c-section is safer for your baby.
• You have a medical condition that may make vaginal birth risky, like diabetes or high blood pressure. Diabetes is when you have too much sugar in your blood. This can damage organs in your body, like blood vessels and nerves. High blood pressure is when the force of blood against the walls of the blood vessels is too high. It can stress your heart and cause problems during pregnancy.
• You’re having multiples (twins, triplets or more).

Complications that affect your baby and labor and birth

• Your labor doesn’t progress. This means it’s too slow or stops.
• Your baby is very large.
• Your baby isn’t in a head-down position for birth. If your baby is in a breech position, it means his bottom or feet are facing down. A transverse position is when your baby’s shoulder is facing down. Some babies can be turned in the womb to move into a head-down position. But a c-section may be safer for your baby.
• The umbilical cord is pinched or you have umbilical cord prolapse. This is when the umbilical cord slips into the vagina before the baby.
• Your baby is in distress. This means he isn’t getting enough oxygen or his heartbeat may not be regular.
• Your baby has certain birth defects, like severe hydrocephalus. This is when fluid builds up on your baby’s brain. It can cause a baby’s head to be very large. Birth defects are health conditions that are present at birth. They change the shape or function of one or more parts of the body. Birth defects can cause problems in overall health, how the body develops or how the body works.

What are the risks of scheduling a c-section for non-medical reasons?

Scheduling a c-section may cause problems for you and your baby because your due date may not be exactly right. Sometimes it’s hard to know exactly when you got pregnant. If you schedule a c-section and your due date is off by a week or 2, your baby may be born too early. Babies born early (called premature babies) may have more health problems at birth and later in life than babies born on time. This is why it’s important to wait until at least 39 weeks for a scheduled c-section.

If your pregnancy is healthy, it’s best to let labor begin on its own. If your provider talks to you about scheduling a c-section, ask if you can wait until at least 39 weeks to have your baby. This gives your baby’s lungs and brain all the time they need to fully grow and develop before he’s born.

If there are problems with your pregnancy or your baby’s health, you may need to have your baby earlier than 39 weeks. In these cases, your provider may recommend an early birth because the benefits outweigh the risks. Having a c-section before 39 weeks of pregnancy is recommended only if there are health problems that affect you and your baby.

If your provider recommends scheduling a c-section, ask these questions:

• Why do I need to have a c-section?
• Is there a problem with my health or the health of my baby makes it necessary to have my baby before 39 weeks? Can I wait to have my baby closer to 39 weeks?
• What problems can a c-section cause for me and my baby?
• What will my recovery be like?
• Can I have a vaginal birth in future pregnancies?

Last reviewed: October, 2018

See also: 39 weeks infographic