Caesarean birth is when a baby is born by abdominal surgery. Some are planned, while others are unplanned or emergency caesareans.
Around a third of babies in the UK are born by caesarean (NHS Digital, 2021). Here we look at the types of caesarean birth and the risks and benefits.
What are the different types of caesarean?
There are two types of caesarean birth:
- A planned (or elective) caesarean is scheduled for before labour is expected to begin. A caesarean birth might be planned for a medical reason or because you’ve chosen this type of birth, alongside discussion and support from healthcare professionals (RCOG, 2015; NHS, 2019).
- An unplanned or in-labour caesarean (sometimes called an emergency caesarean) takes place during labour, or before labour starts if an unexpected medical problem comes up. This happens when a baby needs to be born for their health or yours (NICE, 2021).
As many caesareans are unplanned, you might find it helpful to understand what to expect in that situation.
What does a caesarean birth involve?
A caesarean is when a baby is born through a cut in the lower abdomen and womb. The cut is usually across the body on the bikini line but can also be done vertically, although this is very rare (NHS, 2019).
Obstetricians, who are doctors specialising in care during pregnancy, birth and the postnatal period, carry out caesareans, which take place in an operating theatre in hospital.
During a caesarean, the birth of a baby takes around five to ten minutes. You should be able to have skin-to-skin contact with your baby straight after they are born if that’s what you want, unless there is a medical reason which means this can’t take place. It can take 40 to 50 minutes to complete the procedure, including removing the placenta through the same cut and stitching afterwards (NHS, 2019).
In both planned and unplanned caesareans, you can still ask for your birth preferences to be considered.
You can read more in our article, Having a caesarean: what to expect.
When is a caesarean recommended?
Sometimes, a caesarean is the safest way for a baby to be born. This could be if:
- the placenta is situated near or over the inside of the cervix (placenta praevia), and it could be damaged as the cervix begins to open
- there is a maternal infection, such as genital herpes, which could be passed to the baby during a vaginal birth
- an unexpected situation arises during labour, for example if an assisted birth is unsuccessful
- another medical condition makes this the safest option for giving birth (NHS, 2019; NICE, 2021; Patient, 2021).
You will also be offered a caesarean birth if:
- when monitoring your baby, the health professionals are concerned that they aren’t getting enough oxygen or nutrients
- the baby is lying in the oblique or transverse position (lying horizontally across your pelvis or diagonally with their head in your hip) or is lying feet first
- your baby has a medical condition that makes it safer for them to be born by caesarean rather than vaginally (NHS, 2019; NICE, 2021; Patient, 2021).
There are some other times when a caesarean may be offered. These include:
- if your baby is estimated to be significantly above average weight
- if the mother’s BMI is significantly above average (NICE, 2021).
Statistics for your local hospital on caesarean section rates can be found here.
When a caesarean is not recommended but you want one
You can request a caesarean for any reason, which does not have to be medical (Birthrights, 2021). Some women suffer with anxiety or fear of vaginal birth (tokophobia). In these circumstances, an obstetrician will discuss your reasons with you, and outline the risks of both vaginal and caesarean birth.
You may be offered a referral to the local perinatal mental health team, if your request for a caesarean is mental health related. If the obstetrician doesn’t agree to the request for a caesarean, they must refer your request to a colleague.
Elective repeat caesarean births (ERCS)
If you have already given birth by caesarean, you can discuss the pros and cons of having a planned caesarean or a vaginal birth with your midwife or doctor. Both choices are considered very safe, so the decision may come down to your preferences and priorities (RCOG, 2016; NICE, 2021).
Research shows that three out of four women who plan a vaginal birth after caesarean will have a straightforward birth (RCOG, 2016). You can read more in our articles on planning a vaginal birth after a caesarean (VBAC) and planning a repeat caesarean (ERCS).
Risks and benefits of caesarean section
Benefits of caesarean birth
For some women, a planned caesarean might reduce the chance of:
- problems with bladder control
- pain during the birth
- feelings of anxiety about vaginal birth and loss of control
- feelings of anxiety due to previous trauma or abuse
- vaginal tearing
- a baby being born when appropriate medical specialists are not present, if the baby is unwell.
(RCOG, 2015; NICE, 2021)
Risks of caesarean birth
A caesarean birth is major abdominal surgery, and it can increase some risks to you and your baby. These include:
- wound discomfort and infection
- a longer hospital stay and possible readmission
- a longer recovery time
- increased chance of bleeding after birth that may occasionally lead to hysterectomy (removal of the womb)
- a cut to the baby’s skin during the surgery
- increased chance of blood clots in the legs that can travel to the lungs, if the women is not mobile soon after surgery
- possible complications of the scar and placenta in future pregnancies, occasionally requiring hysterectomy, or causing repeat caesarean, uterine rupture or stillbirth.
(RCOG, 2015; NICE, 2021)
Are there any long-term effects of a caesarean birth for babies?
Not much is known about the long-term effects of having a caesarean birth on babies. Some research suggests children born by caesarean may have a higher chance of conditions like childhood asthma and obesity, but we don’t know to what extent caesarean birth is a factor (NICE, 2021).
If you are considering a planned caesarean, talk through your options through with your midwife, GP or obstetrician. If you’ve recently had a caesarean birth, read our article about recovery after a caesarean birth.
This page was last reviewed in August 2022.
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The RCOG Understanding how risk is discussed in healthcare patient information leaflet can be found here.
Here you can find statistics for your local hospital on caesarean section rates.
Birthrights. (2021) Your right to a caesarean birth. Available at: https://www.birthrights.org.uk/factsheets/right-to-a-c-section/ [Accessed 30th March 2022]
NHS. (2019) Caesarean section. Available at: https://www.nhs.uk/conditions/caesarean-section/ [Accessed 30th March 2022]
NHS Digital. (2021) NHS maternity statistic, England 2020-2021. Available at: https://digital.nhs.uk/data-and-information/publications/statistical/nh… [Accessed 30th March 2022]
NICE. (2021) Caesarean birth. Available at: https://www.nice.org.uk/guidance/ng192 [Accessed 30th March 2022]
Patient. (2021) Malpresentations and malpositions. Available at: https://patient.info/doctor/malpresentations-and-malpositions#nav-1 [Accessed 30th March 2022]
RCOG. (2015) Choosing to have a caesarean section (for non-medical reasons). Available at: https://www.rcog.org.uk/globalassets/documents/patients/patient-informa… [Accessed 30th March 2022]
RCOG. (2016) Birth after previous caesarean patient information leaflet. Available at: https://www.rcog.org.uk/for-the-public/browse-all-patient-information-l… [Accessed 30th March 2022]