Cesarean delivery is a surgery to deliver a baby through a surgical cut (incision) on the abdomen and uterus. It is generally a safe procedure for the mother and baby. There may, however, be a few risks to the health of the mother and baby. These risks are described below.
Risks to the baby:
- Breathing problems: The baby may develop abnormally fast breathing called transient tachypnea of the newborn. Breathing problems generally occur because, in cesarean delivery, the delivery occurs without the start of labor. Thus, there is insufficient clearance of fluid from the lungs of the baby. Breathing problems usually improve within the first two days of delivery.
- Injuries: Rarely, there may be injuries to the newborn from the instruments used during the surgery.
- Effect of anesthesia: The use of regional anesthesia has reduced the chances of anesthesia side effects on the newborn. Some regional anesthesia may also reach the baby. Its sedating effect on the baby, however, is considerably less than that of general anesthesia.
Risks to the mother:
- Excessive bleeding that may require a blood transfusion
- Infections such as endometritis (an infection of the womb lining)
- Injury to the bladder
- Bowel injury
- Reactions to anesthesia or the medicines
- Deep vein thrombosis (formation of blood clots, especially in the deep veins of the legs or pelvic region)
- Potential risk in future pregnancies such as problems with the placenta or the need for a future cesarean delivery. Many women, however, may have a vaginal delivery or vaginal birth after a cesarean delivery (VBAC).
What is a cesarean delivery?
Cesarean delivery is a surgery to deliver a baby through a surgical cut (incision) on the abdomen and uterus. Modern-day cesarean deliveries are generally safe. They may, however, have a higher risk of complications than a vaginal delivery. Having a cesarean delivery does not mean that future deliveries will necessarily be through cesarean delivery. Many women have delivered through vaginal birth after cesarean delivery or vaginal birth after cesarean delivery. However, there may be an increased risk in future pregnancies such as problems with the placenta or the need for future cesarean delivery. There may also be a risk of tearing of the womb or uterine rupture in future pregnancies, especially when a vaginal birth is attempted. The hospital stay and recovery are also shorter in vaginal deliveries compared with those in cesarean deliveries.
Nonetheless, cesarean deliveries are crucial to delivering a baby in situations that may pose a threat to the mother’s or baby’s health. The surgery is done by an obstetrician. Present-day cesarean deliveries are safer because of the advancements such as the preferred use of regional anesthesia instead of general anesthesia and horizontal instead of a vertical incision on the uterus.
When is a cesarean delivery needed?
A cesarean delivery may be done as an emergency surgery or a scheduled or elective surgery.
Emergency cesarean delivery may be done when
- There is placental abruption (a condition in which the placenta separates too soon from the wall of the uterus).
- There is slowing or non-progression of the labor that does not improve with medications.
- There is fetal distress (the baby’s heart rate becomes abnormal because of reduced oxygen supply to the baby).
- There is compression or pinching of the umbilical cord that may affect the baby’s oxygen supply.
- There is umbilical cord prolapse (a condition in which the umbilical enters the birth canal before the baby).
- The baby’s head or body is very large to fit through the birth canal.
Planned cesarean delivery may be done when
- The baby’s position in the uterus is breech (the feet or bottom first) or transverse (sideways).
- Some birth defects are present such as severe hydrocephalus (a condition in which excess fluid builds up in the brain).
- There are some problems with the placenta such as placenta previa (the placenta rests too low in the uterus and covers the cervix).
- The mother has some infections that may make a vaginal delivery risky for herself or the baby such as human immunodeficiency virus (HIV) or an active case of genital herpes.
- There are multiple pregnancies (some cases).
- The mother previously had a uterine surgery or cesarean delivery (many women, however, have delivered through vaginal birth after cesarean delivery or vaginal birth after cesarean delivery).
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