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Elective C-Section: Weighing the Pros and Cons

Unnecessary surgery can pose risks for mother and baby.

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By now you are probably starting to develop a plan for your delivery day.

In most births, the baby passes through the birth canal and is pushed out through the vagina. But sometimes a baby is delivered by surgery. This is called a cesarean delivery, or C-section. In these cases, the doctor cuts through the mother’s abdomen and uterus under anesthesia and lifts the baby out, then stitches the incisions closed.

This type of operation may be performed when a vaginal delivery poses a medical risk to the mother or the baby.

A number of women ask about having a cesarean birth even when there’s no medical reason to do so. This type of birth is called C-section on maternal request and is an elective cesarean section.

Why would some request surgery?

Some women are fearful about the pain of labor and delivery. Some may worry about tearing or stretching the vagina during birth, or about bladder control or the quality of sex after giving birth.

Others may want the convenience or control of a scheduled birth (although nothing is guaranteed). They may live far from a hospital, or they may want to ensure their own doctor will be there to deliver the baby.

Before talking to your doctor about a cesarean that isn’t medically necessary for you or your baby, here are some things to think about.

About C-sections

A C-section carries the risks of a major surgery. These include pain and infection at the incision, dangerous bleeding, blood clots and the possible need for blood transfusions. A C-section is usually more expensive and may require a longer hospital stay. Once home, recovery typically takes longer, and you may miss more work than with a vaginal delivery. Be sure to check with your health plan to see if elective cesareans are covered.

What is full term?

A normal pregnancy is about 40 weeks. The baby is growing throughout this time. The lungs, brain and liver are the last organs to develop fully in the womb. In fact, a brain is thought to grow one-third of its size between weeks 35 and 39. Guidelines recommend waiting until a baby is at least 39 weeks along before doing an elective C-section.

A cesarean also can cause complications with later births. An elective C-section is not recommended for a woman wanting multiple children.

Discuss your concerns

Your doctor can help you weigh the pros and cons of an elective cesarean. Unless there is a medical need for a C-section, vaginal birth is usually the best option for mother and baby alike.

By Ginny Greene, Contributing Editor

American College of Obstetricians and Gynecologists. Your Pregnancy and Childbirth. 6th ed. Washington, DC: ACOG; 2015. Accessed: June 24, 2016.
U.S. Department of Health and Human Services. Pregnancy. Labor and birth. Accessed: June 24, 2016.
American College of Obstetricians and Gynecologists. FAQ. Elective delivery before 39 weeks. Accessed: June 24, 2016.
UpToDate. Cesarean delivery on maternal request. Accessed: June 24, 2016.

Last Updated: June 24, 2016