Risks and benefits of caesarean birth

Overview

A caesarean birth, also called a C-section, is a surgery to deliver a baby through cuts made in the mother's belly and womb. It is done when a vaginal birth is not safe or possible.

Yes, caesarean birth is common. In the UK, around 25% of babies are born this way.

It can affect any pregnant woman. Some women plan a caesarean ahead of time, while others need one urgently during labour.

Symptoms

Common symptoms

• Labour is not progressing (failure to progress)
• Baby is in a breech position (feet or bottom first)
• Baby shows signs of distress (heart rate changes)
• Placenta previa (placenta covering the cervix)
• Multiple pregnancy (twins or more)
• Maternal health conditions like high blood pressure or diabetes

Symptoms in children

• Not applicable — the procedure is for the birth itself.

Symptoms in older adults

• Not applicable for the birth, but older mothers may be more likely to have a caesarean due to health reasons.

Causes

Main causes

• Baby is in a difficult position (like breech)
• Placenta is blocking the birth canal (placenta previa)
• Baby shows signs of distress during labour
• Labour is not progressing as expected
• You have a health condition that makes vaginal birth risky (such as heart disease)
• You have an infection like herpes that could pass to the baby during birth
• You had a previous caesarean and choose a planned one

Risk factors

• Being older than 35
• Having a high body mass index (BMI)
• Having a multiple pregnancy (twins or more)
• Having certain medical conditions (like diabetes or high blood pressure)
• Having had a previous caesarean
• Having a prolonged labour
• Having induction of labour

When to see a doctor

See a doctor urgently if:

• If you experience sudden heavy bleeding during pregnancy
• If you have severe abdominal pain
• If you have a fever with chills

Book a routine appointment if:

• To discuss your birth plan with your midwife or obstetrician
• If you have any concerns about your pregnancy or delivery options

Diagnosis

The need for a caesarean is decided by your healthcare team based on your health, your baby’s health, and how labour is progressing. Your obstetrician or midwife will monitor you and your baby closely.

Tests that may be done

• Ultrasound to check the baby's position and the placenta's location
• Fetal heart rate monitoring during labour
• Blood tests to check for infection or other issues

What to expect at your appointment

If your doctor recommends a caesarean, they will explain why and discuss the risks and benefits. For planned caesareans, you will have time to prepare. For emergency caesareans, things may happen quickly, but the team will keep you informed.

Treatment

A caesarean birth is major surgery. It is done under anaesthesia — usually regional (you are awake but numb from the waist down) but sometimes general (you are asleep). The surgeon makes a cut in your lower belly and womb to deliver the baby. The whole procedure takes about 40 to 60 minutes.

Self-care at home

• Rest as much as possible after birth
• Avoid heavy lifting for about 6 weeks
• Keep your wound clean and dry
• Take over‑the‑counter pain relievers as recommended by your doctor

Medical treatments

To prevent infection, you will be given antibiotics through a drip. You may also receive medication to prevent blood clots. If you have stitches or staples, they will be removed after a few days. Your healthcare team will watch for signs of infection or bleeding.

When is surgery considered?

The surgery itself is the caesarean birth. It is performed when needed. There is no additional surgery for the birth itself.

Living with this condition

After a caesarean, you will stay in hospital for 2 to 4 days. You will be encouraged to get up and move gently to prevent blood clots. You may feel sore and tired. It can take 6 to 8 weeks to feel more like yourself.

Lifestyle tips

• Plan for help at home for the first few weeks
• Avoid driving for at least 6 weeks, or until you can safely do an emergency stop
• Avoid heavy housework and carrying anything heavier than your baby
• Use pillows to support your wound when coughing or sneezing

Diet and exercise

Eat a healthy, balanced diet rich in fruits, vegetables, and protein to help your body heal. Drink plenty of water, especially if you are breastfeeding. Gentle walking is good, but avoid strenuous exercise until your doctor says it is safe.

Mental health and emotional wellbeing

Recovering from a caesarean can be emotionally challenging. Some women feel disappointed about not having a vaginal birth, or they may feel overwhelmed. It is normal to have these feelings. Talk to your midwife or doctor about how you are feeling. They can offer support and connect you with helpful resources.

Prevention

Many caesarean births happen for medical reasons that cannot be prevented. However, maintaining a healthy weight, managing chronic conditions like diabetes or high blood pressure, and attending all prenatal appointments may reduce the chance of needing one.

Vaccines

Not applicable

Screening programmes

Not applicable

Complications

If left untreated

• Infection in the wound or womb
• Excessive bleeding (haemorrhage)
• Blood clots in the legs or lungs
• Damage to nearby organs like the bladder or bowel
• Reaction to anaesthesia

Long-term outlook

Most women recover well from a caesarean. The risks are low when the surgery is performed by an experienced team. After recovery, you can look forward to caring for your baby and your health. Future pregnancies may need special planning, but many women go on to have healthy pregnancies after a caesarean.

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