C-section by request

Some women may prefer to have a cesarean section instead of a vaginal birth, even without medical need. It may be appealing for both the woman and the health care provider to consider cesarean because it helps them plan their schedules. Some women ask for c-section because they are worried about the pain of vaginal delivery.

We do not have enough research to fully compare the risks and benefits of c-section by request with vaginal delivery. Because of this, the decision to have a c-section by request must be based on the individual needs of the woman and her baby.

Concern about pain is usually not a good reason to request c-section. Safe and effective pain management methods are available to help women cope with vaginal delivery. Some of these methods use drugs; others are drug-free.

The risk of late preterm birth
With any cesarean, it's important that the surgery be done at 39 completed weeks of pregnancy or later, unless there's a medical reason for delivering earlier. C-sections may contribute to the growing number of babies who are born "late preterm," between 34 and 36 weeks gestation. While babies born at this time are usually considered healthy, they are more likely to have medical problems than babies born a few weeks later at full term.

A baby's lungs and brain mature late in pregnancy. Compared to a full-term baby, an infant born between 34 and 36 weeks gestation is more likely to have problems with:

  • Breathing
  • Feeding
  • Maintaining his or her temperature
  • Jaundice

It can be hard to pinpoint the date your baby was conceived. Being off by just a week or two can result in a premature birth. This may make a difference in your baby's health. Keep this in mind if you are considering elective c-section.

When a woman is carrying just one baby, c-section by request should be performed only after 39 weeks of pregnancy. The health care provider may also need to check the baby's lungs to be sure they are mature.

If you are planning to have several children, cesarean section by request is not recommended. This is because the risk of placenta previa and accreta rises with each cesarean birth.

If you are considering a c-section by request, talk to your health care provider and be sure you fully understand the risks and benefits. These questions may be useful when you speak to your provider.

  • What problems can a c-section cause for me and my baby?
  • Will I need to have a c-section in future pregnancies?

July 2009

Most common questions

Can I schedule my c-section?

Yes. But more and more c-sections are being scheduled early for non-medical reasons.
Experts are learning that this can cause problems for both mom and baby. If you know you're having a c-section, wait until at least 39 weeks of pregnancy. This helps you make sure your baby has all the time she needs to grow before she's born. You may not have a choice about when to have your baby. If there are problems with your pregnancy or your baby's health, you may need to have your c-section earlier. But if you have a choice and you're planning to schedule your c-section, wait until at least 39 weeks.

What are some reasons to have a c-section?

You may need a c-section if there are medical problems that put you or your baby in danger. For example, you may need a c-section if your baby is too big to pass through the birth canal, or if the baby is in a breech position (feet first) or a transverse position (shoulder first). The best position for your baby is head first. You may need a c-section if your labor is really slow or if the baby's heart rate slows during labor. Other reasons for a c-section include having problems with the placenta or with the umbilical cord, having an infection that you can pass to your baby during birth, and being pregnant with twins or more. If you've had a c-section in a previous pregnancy, you may need to have one in your next pregnancy. If your pregnancy is healthy and there's no medical reason to have a c-section, it's best to plan for a vaginal birth and wait for labor to start on its own. Ask your provider if there are reasons why you may need to have a c-section.

What kind of anesthesia should I get during a c-section?

Most likely you'll have regional anesthesia so you can stay awake for your baby's birth. This kind of anesthesia numbs you from below your breasts all the way down to your toes. If you have an emergency c-section, you may need general anesthesia. General anesthesia makes you go to sleep during the surgery.

©2013 March of Dimes Foundation. The March of Dimes is a non-profit organization recognized as tax-exempt under Internal Revenue Code section 501(c)(3).