Elective Repeat Caesarean Birth

An elective caesarean is a planned caesarean. The date is usually planned in advance, the caesarean birth usually happens in the seven days before your due date, unless there is a reason (related to you or your baby) why your baby needs to be born earlier.

Advantages of elective repeat caesarean birth

The advantages of elective repeat caesarean birth include:

  • virtually no risk of uterine scar rupture (12 per 10,000 women 0.12%)
  • it avoids the possible complications associated with labour. 

However, since caesarean birth is planned within the week before the due date, there is a chance that you will go into labour before the date of your caesarean birth. If this was to occur, please contact Central Delivery Suite as soon as possible to enable a plan to be put into place which could be either to expedite the ceaserean section or proceed with a VBAC if appropriate and agreeable to all.    

Disadvantages of elective repeat caesarean birth

The disadvantages of elective repeat caesarean birth include:

A longer and possibly more difficult operation - a repeat caesarean birth usually takes longer than the first operation because of scar tissue. Scar tissue may also make the operation more difficult and can result in damage to the bowel or bladder. There are rare reports of accidental cutting of your baby at caesarean birth.

Chance of a blood clot (thrombosis) - a blood clot that occurs in the lung is called a pulmonary embolus. A pulmonary embolus can be life threatening (death occurs in less than one in 1000 caesarean births).

There is a longer recovery period - you may need extra help at home and will be unable to drive for several weeks after birth (check with your insurance company).

Breathing problems for your baby - breathing problems are quite common after caesarean birth and usually do not last long. Occasionally, your baby will need to go to the neonatal intensive care baby unit. Three to four in 100 babies (3–4%) born by planned caesarean birth have breathing problems compared with two to three in 100 (2–3%) following VBAC. Waiting until seven days before the due date minimises this problem.

A need for elective caesarean birth in future pregnancies - more scar tissue occurs with each caesarean birth. This increases the possibility of the placenta growing into the scar making it difficult to remove at caesarean (placenta accreta or percreta). This can result in bleeding and may require a hysterectomy. All serious risks increase with every caesarean birth you have.

Planned elective caesarean and going into labour

Telephone the hospital to let them know what is happening. It is likely that an emergency caesarean will be performed once labour is confirmed. If labour is very advanced, or if the labour is early (before 37 weeks), then VBAC may be more suitable. Your obstetrician will discuss this with you.

For more information visit www.nhs.uk/conditions/caesarean-section