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���ϸ����� Langone obstetrician and maternal–fetal medicine specialists perform cesarean delivery, a safe surgical procedure in which your baby is removed from the uterus. A cesarean delivery, also known as a C-section, may be planned, or it may be needed if a complication arises during vaginal delivery. Our doctors also perform repeat cesarean deliveries for people whose prior pregnancies were surgically delivered.

Planned Cesarean

Sometimes, a cesarean birth is planned. This may occur if the baby is in a breech, meaning bottom-first, position, or if the baby is known to have a birth defect called spina bifida.

Cesarean delivery may also be planned if you have had prior surgery on the uterus, such as a myomectomy to remove fibroids.

In addition, carrying more than one baby, having a baby who weighs more than nine pounds, and diagnosis with a condition that makes vaginal delivery risky, such as HIV, are all reasons for a planned cesarean delivery.

Your doctor may also recommend a planned cesarean if you have placenta previa, which occurs when the placenta, the organ that provides the baby with nutrition, blocks the birth canal. This situation can result in substantial blood loss in the parent and is also dangerous for the baby.

Repeat Cesarean Delivery

Some people who have received a cesarean for a past delivery may decide to have a planned cesarean for their next delivery.

Others may want to have a vaginal birth after cesarean (VBAC). In this process, labor is allowed to progress naturally and is closely monitored—a so-called trial of labor. ���ϸ����� Langone obstetricians may then determine that a repeat cesarean delivery, not a vaginal birth, is the safest option for the parent and baby. A repeat cesarean is usually necessary only in a small subgroup of patients.

���ϸ����� Langone doctors are equipped to handle cesarean deliveries quickly and efficiently if a trial of labor is not successful.

Emergency Cesarean

Sometimes, a cesarean delivery must be performed if you or the baby’s health becomes endangered during a vaginal delivery. A cesarean delivery may be necessary if the umbilical cord prolapses, or drops, outside the birth canal, potentially cutting off the blood and oxygen supply to the baby. Our maternal–fetal medicine specialists are available to help with emergency cesarean delivery.

If labor is not progressing, which is what occurs when contractions slow or stop, if the cervix doesn’t dilate, or if the baby shows signs of distress, your doctor may decide to perform surgery.

���ϸ����� Langone doctors are equipped to handle cesarean deliveries quickly and efficiently. One support person is welcome to remain in the room during the procedure

Our Approach to Cesarean Delivery

In a cesarean delivery, an obstetric anesthesiologist provides regional anesthesia to numb the lower half of your body. General anesthesia may be used in an emergency.

Fluids and medication are provided through a vein with IV infusion, and a catheter is inserted into the urethra to drain urine from the bladder. A screen is placed above your waist to block your view of the cesarean delivery incision. It can be lowered enough to see your baby being born.

Your doctor uses an antiseptic to clean your abdomen and makes a small, horizontal incision in the skin above the pubic bone. The surgery involves cutting through tissue, separating muscles, and typically making a horizontal cut in the bottom of the uterus called a low-transverse uterine incision. Your doctor lifts the baby from the uterus and cuts the umbilical cord.

Nurses then perform the Apgar test, which assesses the baby’s health by measuring activity level, heart rate, reflex response, skin color, and breathing rate. They wrap the baby in a blanket and hand the baby to you. Your doctor closes the incision in your uterus with dissolvable stitches but may use staples to close the incision in the skin. These are removed by the doctor at a follow-up appointment. This takes about 30 minutes.

Recovery After Cesarean Delivery

After a cesarean delivery, you spend several hours in a recovery room while you are observed, and your baby stays there too, unless special medical attention is required. You remain in the hospital for up to four days after delivery.

Because a cesarean delivery is an abdominal surgical procedure, it has a higher risk of infection, blood clots, bleeding, and pain than a vaginal birth. After the procedure, your doctor monitors your condition and manages your pain with medication.

A cesarean section may also increase risks with future pregnancies. Placenta previa is more likely to occur. Uterine rupture, in which a weakened part of the uterus tears, can occur at the site of the previous cesarean delivery incision. Our doctors can help you navigate these risks and provide you with support during your next pregnancy.