Cesarean delivery (C-section) is used to deliver a baby through surgical incisions made in the abdomen and uterus.

Planning for a C-section might be necessary if there are certain pregnancy complications. Women who have had a C-section might have another C-section. Often, however, the need for a first-time C-section isn' clear until after labor starts.

If you're pregnant, knowing what to expect during and after a C-section can help you prepare.

Health care providers might recommend a C-section if:

• Labor isn't progressing normally. Labor that isn't progressing (labor dystocia) is one of the most common reasons for a C-section. Issues with labor progression include prolonged first stage (prolonged dilation or opening of the cervix) or prolonged second stage (prolonged time of pushing after complete cervical dilation).
• The baby is in distress. Concern about changes in a baby's heartbeat might make a C-section the safest option.
• The baby or babies are in an unusual position. A C-section is the safest way to deliver babies whose feet or buttocks enter the birth canal first (breech) or babies whose sides or shoulders come first (transverse).
• You're carrying more than one baby. A C-section might be needed for women carrying twins, triplets or more. This is especially true if labor starts too early or the babies are not in a head-down position.
• There's a problem with the placenta. If the placenta covers the opening of the cervix (placenta previa), a C-section is recommended for delivery.
• Prolapsed umbilical cord. A C-section might be recommended if a loop of umbilical cord slips through the cervix in front of the baby.
• There's a health concern. A C-section might be recommended for women with certain health issues, such as a heart or brain condition.
• There's a blockage. A large fibroid blocking the birth canal, a pelvic fracture or a baby who has a condition that can cause the head to be unusually large (severe hydrocephalus) might be reasons for a C-section.
• You've had a previous C-section or other surgery on the uterus. Although it's often possible to have a vaginal birth after a C-section, a health care provider might recommend a repeat C-section.

Some women request C-sections with their first babies. They might want to avoid labor or the possible complications of vaginal birth. Or they might want to plan the time of delivery. However, according to the American College of Obstetricians and Gynecologists, this might not be a good option for women who plan to have several children. The more C-sections a woman has, the greater the risk of problems with future pregnancies.

Like other types of major surgery, C-sections carry risks.

Risks to babies include:

• Breathing problems. Babies born by scheduled C-section are more likely to develop a breathing issue that causes them to breathe too fast for a few days after birth (transient tachypnea).
• Surgical injury. Although rare, accidental nicks to the baby's skin can occur during surgery.

Risks to mothers include:

• Infection. After a C-section, there might be a risk of developing an infection of the lining of the uterus (endometritis), in the urinary tract or at the site of the incision.
• Blood loss. A C-section might cause heavy bleeding during and after delivery.
• Reactions to anesthesia. Reactions to any type of anesthesia are possible.
• Blood clots. A C-section might increase the risk of developing a blood clot inside a deep vein, especially in the legs or pelvis (deep vein thrombosis). If a blood clot travels to the lungs and blocks blood flow (pulmonary embolism), the damage can be life-threatening.
• Surgical injury. Although rare, surgical injuries to the bladder or bowel can occur during a C-section.

• Increased risks during future pregnancies. Having a C-section increases the risk of complications in a later pregnancy and in other surgeries. The more C-sections, the higher the risks of placenta previa and a condition in which the placenta becomes attached to the wall of the uterus (placenta accreta).

  A C-section also increases the risk of the uterus tearing along the scar line (uterine rupture) for women who attempt a vaginal delivery in a later pregnancy.

For a planned C-section, a health care provider might suggest talking with an anesthesiologist if there are medical conditions that might increase the risk of anesthesia complications.

A health care provider might also recommend certain blood tests before a C-section. These tests provide information about blood type and the level of the main component of red blood cells (hemoglobin). The test results can be helpful in case you need a blood transfusion during the C-section.

Even for a planned vaginal birth, it's important to prepare for the unexpected. Discuss the possibility of a C-section with your health care provider well before your due date.

If you don't plan to have more children, you might talk to your health care provider about long-acting reversible birth control or permanent birth control. A permanent birth control procedure might be performed at the time of the C-section.