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Risks

By Mayo Clinic staff

Recovery from a C-section takes longer than does recovery from a vaginal birth. And like other types of major surgery, C-sections also carry a higher risk of complications.

Risks to your baby include:

  • Breathing problems. Babies born by C-section are more likely to develop a breathing problem marked by abnormally fast breathing during the first few days after birth (transient tachypnea). Elective C-sections done before 39 weeks of pregnancy or without proof of the baby's lung maturity may increase the risk of other breathing problems, including respiratory distress syndrome.
  • Fetal injury. Although rare, accidental nicks to the baby's skin can occur during surgery.

Risks to you include:

  • Inflammation and infection of the membrane lining the uterus. This condition — known as endometritis — may cause fever, chills, back pain, foul-smelling vaginal discharge and uterine pain. It's often treated with intravenous (IV) antibiotics.
  • Increased bleeding. You may lose more blood with a C-section than with a vaginal birth. However, blood transfusions are rarely needed.
  • Urinary tract infection. You may develop a urinary tract infection in the bladder or kidneys.
  • Decreased bowel function. Any abdominal surgery slows the movement of waste material through your intestines. Some medications for pain relief may further contribute to this problem, leading to constipation.
  • Reactions to anesthesia. After regional anesthesia, a small number of women may experience a headache caused by a leak of the fluid around the spinal canal into the tissues of the back. Allergic or adverse reactions to the anesthetic also are possible.
  • Blood clots. The risk of developing a blood clot inside a vein — especially in the legs or pelvic organs — is about four times greater after a C-section than after a vaginal delivery. If a blood clot travels to your lungs (pulmonary embolism), the damage can be life-threatening. Your doctors will take steps to prevent blood clots. You can help, too, by walking frequently soon after surgery.
  • Wound infection. An infection at or around the incision site is possible. When a wound is infected, it may open at the skin and release pus.
  • Additional surgeries. Although rare, surgical injuries to nearby organs can occur during a C-section. If this happens, additional operations may be needed.
  • Increased risks during future pregnancies. After a C-section, you face a higher risk of potentially serious complications — including bleeding, placenta previa, abnormal fetal positions and tearing of the uterus along the scar line from the prior C-section (uterine rupture) — in a subsequent pregnancy than you would after a vaginal delivery.
References
  1. Berghella V. Patient information: Cesarean delivery. http://www.uptodate.com/home/index.html. Accessed Aug. 21, 2008.
  2. Berghella V. Cesarean delivery: Postoperative issues. http://www.uptodate.com/home/index.html. Accessed Aug. 21, 2008.
  3. Risks of a Cesarean procedure. American Pregnancy Association. http://www.americanpregnancy.org/labornbirth/cesareanrisks.html. Accessed Aug. 21, 2008.
  4. Reasons for a Cesarean birth. American Pregnancy Association. http://www.americanpregnancy.org/labornbirth/reasonsforacesarean.html. Accessed Aug. 21, 2008.
  5. Creating a positive Cesarean experience. American Pregnancy Association. http://www.americanpregnancy.org/labornbirth/positivecesarean.html. Accessed Aug. 21, 2008.
  6. Landon MB. Cesarean delivery. In: Gabbe SG, et al. Obstetrics: Normal and Problem Pregnancies. 5th ed. Philadelphia, Pa.: Churchill Livingstone Elsevier; 2007. http://www.mdconsult.com/das/book/body/102752869-3/0/1528/181.html?tocnode=54291973&fromURL=181.html#4-u1.0-B978-0-443-06930-7..50021-9_954. Accessed June 23, 2008.
  7. Kennare R, et al. Risks of adverse outcomes in the next birth after a first cesarean delivery. Obstetrics & Gynecology. 2007;109(2):270-276.
  8. Daltveit AK, et al. Cesarean delivery and subsequent pregnancies. Obstetrics & Gynecology. 2008:111(6):1327-1334.
  9. Sun C. Post-lumbar puncture headache. http://www.uptodate.com/home/index.html. Accessed Aug. 22, 2008.
  10. Berghella V. Cesarean delivery: Preoperative issues. http://www.uptodate.com/home/index.html. Accessed Aug. 12, 2008.
  11. About Cesarean childbirth. American College of Surgeons. http://www.facs.org/public_info/operation/cesarean.pdf. Accessed Sept. 9, 2008.
  12. Cesarean birth after care. American Pregnancy Association. http://www.americanpregnancy.org/labornbirth/cesareanaftercare.html. Accessed Sept. 23, 2008.
  13. Cesarean procedure. American Pregnancy Association. http://www.americanpregnancy.org/labornbirth/cesareanprocedure.html. Accessed Sept. 23, 2008.
  14. Berghella V. Cesarean delivery: Technique. http://www.uptodate.com/home/index.html. Accessed Aug. 12, 2008.
  15. Prevention of pertussis, tetanus, and diphtheria among pregnant and postpartum women and their infants: Recommendations of the Advisory Committee on Immunization Practices (ACIP). Centers for Disease Control and Prevention. http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5704a1.htm. Accessed Sept. 22, 2008.
  16. Is it possible to breastfeed after a Cesarean birth? La Leche League. http://www.llli.org//FAQ/cesarean.html. Accessed Sept. 5, 2008.
  17. Grant GJ. Anesthesia for cesarean delivery. http://www.uptodate.com/home/index.html. Accessed Aug. 12, 2008.
  18. Harms RW (expert opinion). Mayo Clinic, Rochester, Minn. Jan. 9, 2009.
  19. Tita AT, et al. Timing of elective repeat Cesarean delivery at term and neonatal outcomes. The New England Journal of Medicine. 2009;360:111.

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Jan. 20, 2009

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