In the United States, one-third of women give birth by Cesarean (a.k.a. C-section), a surgical procedure where your baby is delivered via an incision in your abdomen and uterus.
For being such a common (and medically necessary) procedure, people have a lot of feelings about it—you might have heard that it’s “worse,” a shameful alternative to delivering vaginally. There’s a lot of mommy shaming that occurs around C-sections but the truth is, C-sections can be a safer alternative for both mom and baby—it all depends on your pregnancy and your history.
Since knowledge is power, we asked doctors to help explain when C-sections are typically used, what happens during the procedure, what recovery after a C-section looks like and how they compare to vaginal births.
Reasons For a C-section
It’s true that you can schedule a C-section to avoid having to worry about going into labor. “Sometimes the hardest part of labor and vaginal delivery is the uncertainty,” says Ashely Brant, D.O. an ob-gyn at the Cleveland Clinic. “It’s important for all parties to be flexible and open to changing the plan as labor unfolds.”
That’s not “lazy.” There are a lot of medically valid reasons why your doctor might recommend going this route, says Costa Sousou, M.D., chair of the department of obstetrics and gynecology at Mayo Clinic Health System. Some of the reasons your doctor might suggest planning a C-section:
You have a condition called placenta previa.
Placenta previa is a condition that occurs when the placenta, an organ that develops during pregnancy to provide your baby with nutrients, covers the cervix (the tissue that connects your vagina to your uterus and opens during labor). That can lead to severe bleeding during pregnancy and delivery, says Dr. Sousou, meaning a C-section can be the safer alternative.
You’re pregnant with twins or triplets.
Depending on the babies’ positioning, a C-section may be the safer option.
You’ve had a C-section before.
If you had a C-section with a previous delivery, there can be a small increased risk of uterine rupture (if you have prior uterine scars), explains Tajh R. Ferguson, M.D., an ob-gyn at Beth Israel Deaconess Medical Center in Boston ].
Of course, just because you had a C-section once doesn’t mean it’s 100% certain you’ll need to have one again. “Deciding whether you want to schedule a repeat C-section or if you want to try vaginally calls for very individualized counseling with your physician—much of which is driven by patient preference if all is all else is healthy,” Dr. Ferguson says.
Your baby is breech.
If your baby is not head down (maybe he’s butt down, a.k.a. breech), vaginal delivery is dangerous if not impossible. Your doctor can try a procedure to turn baby head down, but if that doesn’t work, a C-section may be the only option.
You have a history of trauma.
“In rare cases, women may want to avoid vaginal delivery due to other circumstances, for example, a history of sexual assault that makes vaginal exams very difficult,” says Dr. Brant. “In cases like these, the patient should have a thorough discussion with her doctor about the risks and benefits of elective c-section.
Of course, there are plenty of scenarios where your doc might order an unexpected C-section, too. Some of those situations include:
Baby’s heartbeat dropping (which may indicate fetal distress).
You’re not progressing in labor (read: pushing for a long time without any progress).
Your doctor is worried about your health or your baby’s health. “Oftentimes, multiple factors contribute to the decision to have a c-section,” says Dr. Brant. “A doctor will recommend a C-section if the risks of vaginal delivery are thought to outweigh the risks of C-section.”
What to Expect During a C-Section Procedure
If you’re lined up for a C-section, first, a nurse will prep you for the operation in an operating room, putting an IV in your arm or hand so that you can get fluids and medications such as antibiotics during the surgery.