A cesarean (see-SAIR-ee-an) birth is a procedure which allows delivery of a child through the mother's abdomen, when vaginal birth is unsafe or impossible. A horizontal or vertical incision is made in the lower abdomen; a second incision is made in the uterus, through which the baby is delivered. C-sections can be performed under general anesthesia (an-es-THEE-zee-uh), or a uterine anesthetic injected through a tube in the outer spine, known as an epidural (ep-ih-DUR-ul). Typically, a C-section is more painful, and requires longer recovery than a vaginal birth. Most first-time C-sections are a result of prolonged labor, when contractions are weak, or the baby's head is too large to pass through the maternal pelvis, or the baby shows signs of not being able to tolerate labor. The number of cesarean births has increased dramatically since 1970; some people have questioned whether the increase is justified. In part, the trend may be due to women giving birth later in life, when risks are greater. Also, doctors used to believe that once a woman had a C-section, all subsequent births must be C-section. Now it's known that's not always true. Despite the debate, there are many legitimate reasons for performing a cesarean: for example, if the baby is long overdue, isn't getting enough oxygen, is in the breech position, or the mother has active herpes. Since the possibility of having a C-section may not arise until you're already in labor, you should educate yourself in advance. For more information, talk to a doctor, and read a book on cesarean delivery.