Caesarean birth: safety, risks and reasons

What is a caesarean birth?

A caesarean birth is when your baby is born via a surgical operation. This operation is called a caesarean section or c-section.

You might hear caesarean births called caesareans, caesars, caesarean sections or c-sections.

Planned (elective) caesarean

Some caesarean sections are planned for medical reasons or because there are signs late in your pregnancy that you or your baby might have problems with a vaginal birth. You might also have a planned caesarean for personal reasons.

Planned caesareans are sometimes called elective caesareans.

Unplanned (emergency) caesarean

Other caesarean sections are unplanned. These happen when there are problems either with your health or your baby’s health during labour.

These are often called emergency caesareans.

This article explains caesarean birth safety, risks and reasons. You might also like to read more about what to expect from a caesarean birth.

Is a caesarean birth safer than a vaginal birth?

Health problems or pregnancy complications might mean that a caesarean birth is a safer option than a vaginal birth for you and your baby.

In Australia, caesarean births are common and relatively safe.

It’s good to talk with your midwife or doctor about your health, your baby’s health and your birth options. If you have a medical condition or other health concern, it’s important to discuss which kind of birth will be safest for you and your baby.

Why you might have a planned (elective) caesarean birth

You’ve had a caesarean before.
Your baby is positioned bottom or feet first (breech) or sideways and can’t be turned.
You have placenta praevia.
You have a twin pregnancy, with your first baby positioned bottom or feet first.
You have a multiple pregnancy – triplets, quintuplets or more.

You might not have, or need to have, a planned (elective) caesarean birth in these circumstances. You can make the decision based on your midwife’s or doctor’s advice about your situation. For example, if you’ve had a previous caesarean or your baby is breech, you can ask about having a vaginal birth after caesarean (VBAC) or a vaginal breech birth. Some public hospitals have clinics specifically for VBACs and breech births.

If you’re having a planned caesarean, you’ll know the day of your surgery, which means you’ll know when your baby is likely to be born. A planned caesarean also means the birth will usually happen before you go into labour. If you go into labour before your caesarean date, call your midwife, doctor or maternity unit.

Why you might have an unplanned (emergency) caesarean birth

Your baby’s head doesn’t move down through your pelvis during labour.
Your labour doesn’t progress as expected.
Your baby starts getting distressed in labour – for example, there are changes in your baby’s heartbeat.

You can’t have a caesarean birth in a birth centre or if you’re having a homebirth. If you have complications and it looks like you might need a caesarean, you’ll go to the nearest hospital. This might be attached to the birth centre. If you’re at home, you might go by car or ambulance, depending on your stage of labour and whether it’s an emergency.

How to reduce your chances of needing an unplanned (emergency) caesarean birth

Have a support person with you in labour to help you stay calm.
Have a known and trusted midwife with you all the time during labour.
Stay active and relaxed during labour.
Involve your midwife and doctor in decisions about your birth.
Avoid an unnecessary induction, which can increase pain and medical intervention during labour.

What are the disadvantages and risks of caesarean birth?

A caesarean section is major surgery.

Disadvantages and risks for birthing mothers

Birthing mothers who have caesarean sections will probably have:

pain around their abdomens and caesarean wounds
restricted activities for up to 6 weeks – for example, limits on lifting, housework and driving.

Some birthing mothers might also have:

more blood loss than usual (haemorrhage)
blood clots
infection of their wound and bladder or in the lining of their uterus
fever caused by infections or by other factors related to the surgery
side-effects from the anaesthetic, including nausea, drowsiness, shivering or itchiness
increased risk of postnatal depression
a higher chance of caesarean birth for future births
scar tissue in their abdomen, which can cause ongoing pain.

After you’ve had a caesarean birth, there’s a higher risk of medical problems for each pregnancy and birth you have after that. For example, the placenta is more likely to grow into or over the scar inside your uterus. Also, the uterus is more likely to tear or rupture in future pregnancies. In rare cases this can lead to a hysterectomy (removal of the uterus).

The overall risk of these complications is low.

Risks for babies

Babies born via caesarean section are more likely to need time in the special care nursery or neonatal intensive care unit (NICU), but this is usually for less than 48 hours.

Caesarean birth rates at public hospitals tend to be lower than at private hospitals. If you want to know about a hospital’s caesarean birth rates, ask your midwife or doctor. You can also check caesarean birth rates for some hospitals online.

How you might feel about having a caesarean birth

It’s common to have strong feelings, expectations and preferences about giving birth.

You might feel fine about giving birth via caesarean section, or you might feel disappointed or sad about not giving birth vaginally.

It can help to talk through your feelings with your partner, family, friends and your health care professionals. You can also call the Pregnancy Birth and Baby Helpline on 1800 882 436 for free advice and counselling, 7 days, 24 hours.