How C-Sections Work

Planned C-sections

Babies born by C-section, like this quadruplet in China, can be at risk for complications.
Babies born by C-section, like this quadruplet in China, can be at risk for complications.
China Photos/Getty Images

Planned C-sections are scheduled well before labor begins. There are two subgroups: indication-based and patient-requested.

Indication-based C-sections are usually scheduled at the doctor's request when a patient suffers from, or is at great risk of, a medical problem that could result in labor that would harm her or the baby. When a child is in the breech (feet-down) position, vaginal delivery is dangerous. Large babies (more than 9 pounds) are often delivered by planned C-section. Mothers who suffer from chronic conditions that could be exacerbated by labor, like diabetes or heart disease, often plan C-sections.

Multiple births, which are more common these days because of the increased use of fertility medications, are usually an indication for a C-section. The doctor will opt for a C-section when there are three or more fetuses in the womb, or when twins are conjoined or sharing one amniotic sac. Women who have had previous C-sections will often have a planned C-section.

One of the advantages of a planned C-section is the assurance that you will be at the hospital during peak hours, when a full staff is working. The risks of a planned C-section are also lower than those of an emergency operation.

Patient-requested C-sections (planned, without medical indications) are a growing trend in the United States. The National Institute of Health estimates that, in 2004, 4 to 18 percent of C-sections were performed on maternal request instead of for medical reasons [source: NIH]. While the NIH has admitted that these numbers are difficult to validate, they are sure that this type of C-section is becoming more and more common.

We know that the risks of C-sections are greater than risks of vaginal birth, at least with your first pregnancy. So why are women opting for C-sections, even for their first birth? Some theorize that the combination of improved C-section safety, along with increased maternal age, has lead to women being able to control when and how they are going to give birth. This type of control is attractive to women who are balancing family and career -- they can perfectly plan maternity leave, right down to the date of the last conference call. Another popular theory is that some women, fearing the pain of vaginal delivery and wanting to avoid urinary incontinence, jump at the chance to give birth via C-section.

Whatever the reasoning, doctors are quick to point out that women should not make this decision lightly. One C-section increases the necessity for another with the next child -- and the risk of serious complications increases for subsequent C-sections. The NationaI Institutes of Health has guidelines for patient-requested C-sections. To ensure proper fetal lung maturity, they should not be scheduled before 39 weeks of pregnancy. If a delivery is scheduled before this time the fetus' lung maturity must be verified before delivery.

No matter the reason, millions of women have C-sections every year. So what should a mom expect after she's been wheeled out of the operating room and into her hospital room? That's what we will discuss in our next section.