A cesarean section, or c-section as it is more commonly known, is a surgical procedure designed to deliver a baby through a cut made in the belly and the uterus, when a vaginal birth is considered to be dangerous for the mother or the baby.

While in most cases a vaginal birth is far less risky than a c-section, there are times when it is medically necessary for this surgery to take place. It could be that the mother has specific health problems that would make a vaginal delivery dangerous, or it may need to be carried out in an emergency when the health of the mother or baby is at risk during delivery.

However, c-sections are not always carried out for medical reasons. In fact, elective or planned c-sections are becoming increasingly common here in the U.S.

Reasons for a Medical C-Section

Women who have had a previous c-section, may be identified as having to undergo the same procedure during subsequent pregnancies, although this is not always the case. It is true that the more c-sections a woman has had, the greater the risk of complications in further pregnancies, but there are some who can and do have successful vaginal births after a c-section.

Women who suffer with infections such as genital herpes or HIV may need to have a c-section to avoid passing the infection on to the baby during a vaginal birth. Other medical conditions, such as high blood pressure or diabetes, might also mean a c-section is safer. And of course, complications during pregnancy, such as placenta previa which could result in dangerous bleeding during a vaginal birth, would mean that a c-section is the safer option.

An emergency c-section would also be necessary if a baby were in distress with a rising heartbeat during a vaginal delivery. It may be the case that the baby is not getting enough oxygen, which then runs the risk of brain damage. The medical professionals in attendance would need to decide if the risk to the child were too high to continue with the vaginal delivery.

A c-section might also be required for babies that are measuring large, as it may be extremely difficult for the mother to give birth, especially if her birth canal is quite small.

Reasons for an Elective C-Section

An elective c-section is one in which there is no medical reason for the procedure. So why would a woman choose to have surgery when it is not necessary?

Some people believe that a c-section will be safer and easier. They want to avoid the pain of contractions and delivery and believe that a c-section is the obvious choice. Then there are those who have a genuine fear of giving birth, as well as some who would find a vaginal birth too traumatic due to events in their past, such as sexual abuse.

FindACode.com, providers of an easy-to-use medical coding site, say that whatever the reason for choosing a c-section, it is important to be aware that not all insurance companies will cover elective c-sections because having one increases the risk of complications in future pregnancies. Some will cover an elective c-section if it does not pose a substantial risk but will not reimburse the full amount for a medical c-section. It is therefore important to note the correct CPT codes for the procedure to avoid a claim being denied, delayed or only partially reimbursed.

It is also worth remembering that a c-section is not without risk. It is a surgical procedure that carries the risk of infection and heavy blood loss. In addition, the recovery time for a c-section is much longer than for a vaginal birth.