C-Section: Reasons, Procedure, Risks and Recovery

What Is a C-Section?

A C-section (also referred to as a cesarean) is the surgical delivery of a baby through an incision made into the abdomen and uterus. When a doctor determines that it is not possible or safe to deliver the baby vaginally for either the mother or the baby, a C-section may be done before labour or during labour.

Why Is a C-Section Performed?

Your doctor may decide to do a planned C-section for many different reasons. Some of these include the following:

• A baby whose head size is larger than what can safely go through the mother's pelvis
• A previous C-section
• Multiple babies
• Baby in a breech position

In addition, certain medical conditions, including heart conditions, placenta previa, or an active genital herpes infection, could make a C-section safer than a vaginal delivery.

When a C-section is unplanned, it is due to complications in labor. For example, the baby's umbilical cord is compressing or prolapsing, there is a separation of the placenta from the uterus, or symptoms are showing that the baby is distressed.

Planned vs Emergency C-Section

A planned C-section is when your healthcare provider schedules the C-section before you go into labour. This is because your healthcare provider believes that a vaginal delivery may not be safe or possible for you.

An unplanned or emergency C-section occurs when unforeseen events occur while you are in labour. The majority of unplanned C-sections are not emergent. 

An emergency C-section occurs when your baby's life is in danger due to potential complications and must be delivered immediately.

How Is a C-Section Performed?

• Before the procedure: You will sign all the required consent forms and speak with an anesthesiologist about anaesthesia options.
• Preparation: Your healthcare provider will insert a urinary catheter to prevent urine retention, attach monitoring equipment, and provide an IV line to administer fluids and medications.
• Making the incision: Once you are taken to the operating room, your abdomen will be cleansed with antiseptics and covered with sterile drapes. Your obstetrician will make an incision through your skin and abdominal wall, followed by an incision in your uterus.
• Delivering the baby: Your obstetrician will bring your baby out through the uterine incision, cut the umbilical cord, and remove the placenta.
• Closing the incisions: Finally, your obstetrician will close both incisions using sutures or staples.

What Type of Anaesthesia Is Used for a C-Section?

Regional anaesthesia (a spinal block or epidural) is most commonly used for C-sections so that you can stay awake during the birth of your child. 

However, general anaesthesia can be used in some cases where you will be placed under general anaesthesia and therefore asleep during the procedure.

How Long Does a C-Section Take?

The length of time needed to perform a C-section varies depending on whether it is planned or an emergency. Typically, it takes about 1 hour and 15 minutes to complete the entire process from start to finish. If, however, it is an emergency situation, you can expect the surgery to be completed within minutes.

Risks and Possible Complications of a C-Section

As with any type of major surgery, C-sections come with their own set of risks and possible complications that are greater than those associated with vaginal deliveries. Examples of complications that may arise include

• Infection
• Excessive blood loss
• Blood clots
• Damage to other internal organs (such as the bladder or bowel)
• Risks from general anaesthesia
• Injury to your baby

Additionally, the opening made in your uterus can weaken your uterus wall. Having had a C-section in your current pregnancy may also affect your ability to recover postpartum and increase the possibility of developing chronic pelvic pain, as well as having additional C-sections in subsequent pregnancies. 

Your baby may also face increased risk factors for respiratory issues and difficulties with nursing.

C-Section Recovery: What to Expect

After a C-section, most women spend at least 3-4 days in the hospital. Most of the time, you will still have some abdominal tenderness after a C-section for several weeks. 

You may experience mild to moderate pain from the incision site (abdominal), general stomach discomfort, and/or "gas pains," as well as some discomfort when you inhale deeply and exhale slowly.

Depending on your doctor's orders, it could take anywhere from 4 to 6 weeks before you are fully recovered from a C-section. In addition, there may be limitations placed on you by your physician regarding lifting objects and engaging in strenuous physical activity. 

Some common concerns experienced post-C-section include cramps and vaginal spotting/bleeding, which typically last up to 6 weeks.

Tips for a Comfortable C-Section Recovery

Some tips for a comfortable C-section recovery include the following:

• Take care of yourself physically and mentally after having a C-section by giving your body time to recover.
• Ask family/friends for assistance with daily tasks such as food preparation, household chores, and running errands.
• Pay close attention to your physician's advice concerning both the types of medications you may use for pain relief as well as any restrictions they place upon your ability to perform specific physical actions.
• Do not attempt to drive for approximately 2 weeks following a C-section. Prior to resuming driving, ensure you can comfortably move your body and apply gentle pressure to the accelerator/gas pedal.
• Do not engage in sexual intercourse until instructed to do so by your healthcare provider. This is typically for at least 6 weeks postpartum.
• Always use sanitary napkins instead of tampons until you are no longer experiencing vaginal bleeding/spotting.

When Should You Contact Your Doctor After a C-Section?

Contact your doctor after a C-section if

• Your incision area appears red or swollen, has developed pus, or is oozing fluid
• You develop a high temperature, chills, flu-like symptoms, extreme lower pelvic discomfort, severe cramping, or excessive bleeding

Foul-smelling vaginal discharge also warrants immediate medical evaluation.

Can You Have a Vaginal Birth After a C-Section?

Yes, some individuals may be able to give birth vaginally after having had a C-section. The decision to pursue vaginal birth after a C-section (VBAC) depends upon your medical history as well as the circumstances surrounding your previous C-section. 

Examples of criteria used to evaluate suitability for VBAC include the type of uterine incision made (i.e., low transverse incision), whether you are carrying multiples (twins/triplets), and what led to your previous C-section.

References

• Dahlke, J. D., Mendez-Figueroa, H., Maggio, L., Sperling, J. D., Chauhan, S. P., & Rouse, D. J. (2020). The case for standardizing cesarean delivery technique: Seeing the forest for the trees. Obstetrics & Gynecology, 136(5), 972–980. 
• Nieto-Calvache, A. J., Ramasauskaite, D., Palacios-Jaraquemada, J. M., et al. (2025). Complex cesarean section: Surgical approach to reduce the risks of intraoperative complications and postpartum hemorrhage. International Journal of Gynecology & Obstetrics, 168(3), 987–998.
• American College of Obstetricians and Gynecologists. (2025). Quality-improvement strategies for safe reduction of primary cesarean birth: ACOG Committee Statement No. 17. Obstetrics & Gynecology, 145(5), 542–552.
• Brown, R. C., & Mulligan, A. (2023). “Maternal request” Caesarean sections and medical necessity. Clinical Ethics, 18(3), 312–320.
• Sung, S., Mikes, B. A., Martingano, D. J., et al. (2024). Cesarean delivery. In StatPearls. StatPearls Publishing.