Additionally, there are stigmas surrounding elective C-sections, along with a slightly higher rate of potential complications, as there are risks to any surgery. We spoke to reproductive experts about elective C-sections so you can be informed about the risks (and rewards) involved in this newly prevalent birthing method.
What Is a C-Section?
A C-section is a birthing method where a baby is delivered via surgical cuts through the abdomen and the uterus. The Centers for Disease Control and Prevention (CDC) reports that just over one in three births is a C-section delivery, a trend that has been reportedly on the rise. About 2.5% of all C-sections are planned, not emergent or medically indicated.
Reasons Doctors Schedule C-Sections
Historically, C-sections have been performed when the health of the pregnant person or fetus is at risk. They might be recommended if labor isn’t progressing properly; if the baby is in distress or in an unusual position (such as breech); if the pregnant person is carrying multiples; if there’s another health concern like a blocked birth canal or issue with the placenta; or if there has been a previous C-section in close temporal proximity to the birth. Mental health sometimes plays a role in scheduling a C-section as well. “[Some birthing people] may have anxiety or prior sexual trauma…and may elect for a cesarian section,” explains Jennifer Roelands, MD, an OB/GYN trained in integrative medicine and who has performed over 2,500 C-sections during her 15-year clinical career. “The thought of [vaginal] labor can be too much for some patients who want to have a particular birth experience.”
What If I Prefer a C-Section?
As a parent, I have undergone two full-term C-sections: one medically necessary, and one elective. For my first C-section, my baby was breech; I had no choice in the matter. In the second, I chose to undergo an elective C-section. For me, the reasons were clear: I knew the process and felt safer as a birthing person in the operating room with my OB/GYN. Asking for this comfort did not feel selfish or dangerous, and my doctor encouraged and supported my decision. Other pregnant people make similar choices. “[Pregnant people] may not wish to labor or may wish to avoid the perceived trauma of vaginal birth,” explains Cynthia Flynn, MD, an OB/GYN and surgeon with JustAnswer. “Some moms, especially those who are older or conceived with IVF, may perceive a C-section as safer.” Sandy Dorcelus, DO, of NYU Langone Hospital-Long Island, points out that some birthing people might be attracted to the predictability of a scheduled C-section surgery. However, both she and Dr. Flynn want to reassure pregnant people that vaginal delivery is safe—and that typical complications, such as tearing and pelvic floor issues, are both common and easily treatable. “Tears due to vaginal delivery are [usually] first and second-degree tears, and can be repaired easily. They also heal well,” Dr. Flynn explains. Dr. Roelands confirms, “Vaginal delivery is mostly safe for everyone, and the healing time is [usually] quicker [than a C-section]. We also know it is healthy for the infant to be exposed to bacteria from the mother’s vagina for long-term health. And most women get to bond quicker with the infant compared to a cesarian section.”
Will Doctors Even Schedule a Voluntary C-Section?
The answer is yes—after informed consent and proper counseling. Adi Davidov, MD, associate chair and director of obstetrics and gynecology at Staten Island University Hospital confirms this. “After a patient is fully counseled and understands the risks and benefits of C-section [versus] vaginal delivery, most doctors would agree that women have the right to ultimately chose the route of their delivery,” Dr. Davidov explains. Dr. Roelands agrees. “There should be no reason [a doctor] should say no,” she says. “The American College of Obstetrics and Gynecology (ACOG) advises that women can elect for a cesarian section if they choose.” But there are a few other things for pregnant people to consider. Vaginal deliveries are typically less expensive than C-sections, according to a 2020 Health Care Cost Institute study. However, anyone could elect for a voluntary C-section, regardless of class, explains Dr. Roelands. “As a physician, we do not get paid more for a cesarian section over a vaginal delivery,” she adds. “The hospital can technically bill more for it, but a health care contract with an insurance company usually has a set fee for delivery, regardless of how it happened. So, a doctor or hospital is not incentivized to choose a cesarian section.” Dr. Flynn puts it plainly: “I think most doctors do offer voluntary C-sections in the medical-legal climate that exists today. It should not be hard to find one that does.”
Questions to Ask Your Healthcare Provider
If you are considering an elective C-section, it is important to speak to your doctor and lay out your choices upfront. Most C-sections must be scheduled to occur at or after 39 weeks. “I think bringing up that you are interested in a cesarian section instead of a trial of labor is essential,” Dr. Roelands says. “Be honest about why you feel this is the right choice for you.” In the end, the decision is between the birthing parent and their doctor. “You are entitled to have [a C-section] if you choose, as long as you have been informed of the risks related to the procedure and how they pertain to you specifically,” Dr. Roelands adds.
A Word From Verywell
Elective C-sections are a complicated choice that have nevertheless gained a foothold in U.S. medicine for pregnant people. Like any birth, elective C-sections come with risks and benefits. However, if you and your OB/GYN or healthcare provider approach the question of opting for this birthing method, it can be a safe and rewarding way to deliver your child.
