Feature Archive

The Truth About C-Sections

Pregnant and thinking about having a C-section? Learn about the risks, benefits, and recovery.

By Heather Hatfield
And Andrea Hecht
WebMD Feature

Reviewed by Louise Chang, MD

Ellen Spencer, 40, of Hanson, Mass., is recovering from a cesarean section. With a 1-month old to take care of, and her older toddler underfoot, bouncing back from major surgery isn't easy.

"I knew I was going to have a C-section," Spencer tells WebMD. "I had abdominal surgery a couple of years ago to remove some fibroids in my uterus, and as a result, my doctor thought it was the better option over going natural. But the recovery has been tougher and longer than I thought it would be."

Despite the slow-going recovery, the convenience of knowing exactly when she was going to have the baby made planning easy, especially with a busy job. And for out-of-town family, making the trip to Massachusetts to welcome the newborn was scheduled and coordinated well in advance.

Spencer's situation is increasingly common: Today, C-sections represent 31.8% of all births in the U.S. annually -- that's more than 1.3 million births. And that number continues to rise. In fact, in the last decade, the rate of C-sections in the U.S. has grown by more than 50%.

With the numbers inching upward, it's important for expectant moms to understand what a C-section means for their bodies, and their health. Here, experts explain the pros and cons of C-sections, why the C-section rate is rising, and what recovery from a C-section is really like.

Pros and Cons of C-sections

Simply put, a C-section is a surgical procedure in which a baby is delivered through a mother's abdomen.

Nearly one in three women in the U.S. deliver their babies by C-section, either for elective reasons, or because of a risk to mother or child.

As with any surgical procedure, there are benefits and disadvantages to C-sections that need to be carefully considered.

"There are benefits to a C-section, especially practically speaking," says Iffath Hoskins, MD, chair of the department of OB/GYN at Lutheran Medical Center in Brooklyn, N.Y. "A mom will know in advance, if it's a planned C-section, when she will have the baby."

Another advantage, Hoskins says, is knowing that you may have important resources available, like neonatologists who can help if there are issues with the baby.

Although C-sections can offer conveniences, they also carry risk.

"Women really need to understand that a C-section is major abdominal surgery," says Jan Kriebs, a certified nurse mid-wife in the University of Maryland Medical Center's obstetrics, gynecology, and reproductive sciences department. "While a team of health care professionals, including an OB, your mid-wife, and nurses work together for a successful outcome, C-sections are very serious."

The procedure involves an incision through the skin, abdomen, muscle, and then into the uterus. From start to finish, including pre- and post-op, a typical C-section lasts 3-4 hours.

"Because we do so many so often, people are lulled into a false sense of security," Hoskins says. "While the process usually works very well, we are cutting into abdomen, adjusting the organs, and making incisions near the bladder and bowel."

As a result, there could be damage to the surrounding organs, excessive bleeding, or an infection, Hoskins says.

For women who have three or more C-sections, the risk rises even further.

"The placenta could be deeply attached to the uterus because of scarring from previous C-sections, and it could be difficult to get out, which means heavy bleeding, therefore a higher chance of needing a blood transfusion, or needing hysterectomy just to save the mother's life," Hoskins says.

He says that 40% or more of women having three or more C-sections will experience these complications, so keeping the procedure limited to those that are medically necessary could be life-saving.

Rising Numbers

Despite the risks, the number of C-sections being performed in the U.S. continues to climb, for several reasons.

"Physician training and willingness to use instruments like forceps and vacuum has decreased," says Katherine Economy, MD, MPH, a maternal fetal medicine specialist in the department of OB/GYN at Brigham and Women's Hospital/Harvard Medical School. "And if you haven't been trained on how to properly use these tools when the situation warrants it, then you're more likely to turn to a C-section."


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