A C-section, also called a cesarean section or cesarean delivery, is a surgical procedure used to deliver a baby through incisions in the lower belly and womb (uterus). C-sections are common. About one-third of births in the United States are C-section deliveries. Although a C-section is a major operation with risks, it is often the safest option for certain pregnancies. Most women recover well and can safely have future pregnancies.

A C-section is a surgery to deliver a baby through incisions in the lower abdomen and womb. The incision in the abdomen is usually horizontal. The procedure is typically performed in a hospital. A surgeon opens the fluid-filled amniotic sac that surrounds the baby, delivers the baby, and closes the incisions with stitches or staples.

Most C-sections are done while the woman is awake. Spinal or epidural anesthesia numbs the lower body while the mother remains awake and can see and hear the baby. The surgery usually takes about 40 to 60 minutes. After delivery, the medical team checks the baby’s breathing and vital signs. The mother can often hold the baby soon after birth.

A C-section may be needed when vaginal birth is not possible or safe for the woman or baby. A woman may be a good candidate for a C-section in these situations or when she requests the procedure after discussing all options. Reasons for a C-section may be medical or nonmedical and may arise before or during labor. Doctors consider each woman’s medical history, pregnancy details, and personal preferences when deciding whether a C-section is the safest option.

Reasons for having a C-section include:

• Maternal health reasons, including infections that could pass to the baby during vaginal birth (such as an active genital herpes outbreak at the time of labor or HIV that is not well controlled near delivery), certain previous surgeries on the womb, or, less often, serious medical conditions that make labor unsafe
• Reasons involving the baby, including an abnormal position, such as feet first (breech) or sideways (transverse lie); a very large baby, especially when the woman has diabetes; certain birth defects; or some pregnancies with twins and most with triplets or more babies
• Reasons related to labor, including labor that is not progressing, excessive vaginal bleeding, or changes in the baby’s heart rate that suggest the baby is not tolerating labor well
• Problems with the placenta or umbilical cord, including placenta previa (placenta covering the birth canal), placenta accreta spectrum (placenta growing too deeply into the wall of the womb), placental abruption (placenta separating from the womb before birth), or umbilical cord prolapse (cord entering the birth canal before the baby)
• A previous C-section when the woman is not a candidate for, or chooses not to try, vaginal birth after cesarean (VBAC)
• A request for a C-section for personal reasons, such as anxiety about childbirth or a previous traumatic experience, after counseling and discussion; experts recommend that a planned C-section for these reasons not be done before 39 weeks of pregnancy

If there is time to plan, doctors and midwives will discuss the risks and benefits of a C-section compared with vaginal birth.

Medical tests and checks before a C-section help the care team plan for the surgery and assess safety. They are usually completed during a preoperative appointment.

• Blood test: Checks for anemia, which means a low level of red blood cells, confirms blood type, and screens for antibodies in case a blood transfusion is needed
• Allergy review: Identifies allergies to medicines or anesthesia
• Vital signs check: Assesses overall health and readiness for surgery
• Fetal heart monitoring: Checks the baby’s well-being before delivery; an ultrasound may also be done to confirm the baby’s position and the location of the placenta
• Anesthesia review: An anesthesiologist reviews health history and medicines to plan the safest type of anesthesia

Doctors may also review the woman’s medical history and perform a physical examination to check for conditions that could affect anesthesia or surgery.

Preparation for a C-section involves several steps to support safety and comfort.

• Fasting: For a planned C-section, women are usually asked not to eat solid food for about eight hours before surgery, though clear liquids may be allowed until about two hours before. This reduces the risk of problems with anesthesia.
• Medicines: Medicines given before surgery may include antibiotics, given within an hour before surgery, to prevent infection, medicine to prevent nausea, and antacids to reduce stomach acid.
• Hospital gown: The woman changes into a hospital gown for the procedure.
• Catheter placement: A thin, flexible tube is placed in the bladder to keep it empty during surgery, usually after the anesthesia takes effect
• IV line: A thin tube is placed in a vein so fluids, medicines, or blood can be given if needed.
• Clot prevention: Inflatable compression sleeves may be placed on the legs to help prevent blood clots.
• Consent: Signing a consent form confirms understanding of and agreement to the procedure.
• Questions: The preoperative appointment provides an opportunity to ask questions and discuss concerns.

Women may be advised not to shave the pubic area before surgery because shaving can increase the risk of infection. If hair removal is needed, hospital staff usually use clippers.

During a C-section, the surgical team follows a series of steps to deliver the baby safely.

• Anesthesia: Most C-sections use spinal or epidural anesthesia, numbing the lower body while the woman remains awake. General anesthesia may be used in an emergency.
• Positioning: The woman lies on an operating table, which may be tilted slightly to the left to keep the womb from pressing on major blood vessels and to maintain blood flow to the baby.
• Surgical drape: A screen is placed across the body so the woman cannot see the operation. The woman can still hear the baby and may be able to hold it soon after delivery.
• Incision: The surgeon usually makes a horizontal cut about four to six inches long across the lower belly. A vertical cut may be used in some cases, such as certain emergencies or placental problems.
• Opening the womb: The surgeon opens the womb and amniotic sac and delivers the baby through the opening. The baby is usually delivered within about 10 to 15 minutes after surgery begins.
• Cord clamping: The umbilical cord is clamped and cut. In healthy babies, clamping is often delayed for 30 to 60 seconds, which can improve the baby’s blood and iron levels.
• Delivery: The baby is lifted up so the mother can see the baby and, if the baby is well, may be brought over for skin-to-skin contact. A pediatrician may provide immediate care if needed.
• Placenta delivery: The placenta is usually delivered with gentle pulling on the umbilical cord.
• Closing the incisions: The womb is closed with dissolvable stitches. The layers of the abdomen are closed, and the skin is closed with stitches, staples, or surgical glue.
• Recovery: The woman is moved to a recovery room and closely monitored, usually for one to two hours. Pain relief, eating and drinking soon after surgery, and breastfeeding support are offered.

A C-section is generally safe, but like any surgery, it carries risks and possible complications for both the woman and baby.

• Infection: The wound or lining of the womb may become infected. Signs may include fever, redness, swelling, worsening pain, or discharge from the wound.
• Blood clots: Clots may form in the legs (deep vein thrombosis) or travel to the lungs (pulmonary embolism), which can be dangerous.
• Excessive bleeding: Heavy bleeding may require a blood transfusion or further surgery; rarely, removal of the womb (hysterectomy) is needed to control bleeding.
• Injury to nearby organs: In rare cases, the bladder, bowel, or the tubes connecting the kidneys to the bladder (ureters) may be damaged.
• Breathing difficulties in the baby: Babies born by C-section, especially planned C-sections done before 39 weeks and without labor, may have temporary breathing problems.
• Accidental cuts: Rarely, the baby may receive a small cut when the womb is opened. These cuts are usually minor and heal well.
• Anesthesia-related problems: Side effects can include a drop in blood pressure, itching, nausea, or a headache after spinal or epidural anesthesia; serious complications are rare.
• Risks in future pregnancies: A C-section can increase the risk of placenta previa, placenta accreta (placenta growing into the muscle of the womb), or the womb tearing along the scar during a later pregnancy. These risks increase with each additional C-section.

Recovery after a C-section usually takes longer than recovery after vaginal birth. Most women stay in the hospital for two to four days.

• Pain and discomfort: The belly may be sore for several days or weeks. Pain medicines such as acetaminophen or ibuprofen are often used. Stronger pain medicines may be prescribed for a short time if needed.
• Wound care: A dressing covers the incision for about 24 to 48 hours. The wound should be gently cleaned and dried daily, and loose, comfortable clothing is recommended.
• Activity: Gentle walking and movement help reduce the risk of blood clots. Lifting anything heavier than the baby should be avoided for several weeks. Driving is usually possible once the woman is no longer taking opioid pain medicine and can move comfortably, often after about two weeks. Exercise and sex can usually resume after about six weeks, once a doctor confirms they are safe.
• Bleeding: Vaginal bleeding may last up to six weeks. Menstrual pads are recommended instead of tampons to reduce the risk of infection.
• Stitches or staples: Stitches or staples that do not dissolve are usually removed within about three to seven days. The scar usually fades over time and is often hidden by pubic hair.
• Breastfeeding and bonding: Support is available for breastfeeding and caring for the baby.
• Warning signs: Contact a doctor right away for fever, heavy bleeding, worsening belly pain, redness or discharge at the incision, pain or swelling in one leg, chest pain or trouble breathing, or a severe headache or vision changes.
• Emotional health: Mood changes are common after birth. Sadness or anxiety that lasts more than two weeks may be a sign of postpartum depression and should be discussed with a doctor.

Most women can gradually return to normal activities. A postpartum checkup within the first few weeks after delivery helps confirm that recovery is on track.

The alternative to a C-section is vaginal birth, which may be possible in many cases. Doctors may support vaginal delivery unless there are clear risks.

• Vaginal birth: For most pregnancies, vaginal delivery is safe and preferred when there are no complications.
• Assisted vaginal delivery: In some cases, forceps or a vacuum device may help deliver the baby.
• Turning a breech baby: If the baby is in the breech position, a doctor may try to turn the baby head down by pressing on the belly (external cephalic version), usually around 37 weeks, which may make vaginal birth possible.
• Vaginal birth after cesarean: Many women who have had a previous C-section can try to have a vaginal birth in a later pregnancy. This depends on the type of incision on the womb, the number of previous C-sections, and the reason for the earlier C-section. About 60% to 80% of women who try a VBAC deliver vaginally.

The outlook for women who have a C-section and their babies is generally good. Most recover well and can safely have future pregnancies. Recovery may take longer than after vaginal birth, but most women return to normal activities within about six weeks.

Many women who have had a C-section can have a vaginal birth in a later pregnancy, though some may need another C-section. The chance of a successful vaginal birth depends partly on the reason for the first C-section, while risks such as placenta accreta and the womb tearing depend on the type of incision on the womb and the number of previous C-sections.

This article was medically reviewed in September 2026.