This guideline covers when to offer and discuss caesarean birth, procedural aspects of the operation, and care after caesarean birth. It aims to improve the consistency and quality of care for women and pregnant people who are thinking about having a caesarean birth or have had a caesarean birth in the past and are now pregnant again.
For information on related topics, see our women's and reproductive health summary page.
In September 2023, we updated the recommendations on the use of neuraxial opioids for postoperative pain relief, and monitoring for women and pregnant people who have had neuraxial opioids.
This guideline includes updated recommendations on:
It also includes recommendations on:
- benefits and risks of caesarean and vaginal birth
- prevention and management of hypothermia and shivering
- surgical techniques for caesarean birth
- care of the woman after caesarean birth
- recovery after caesarean birth
- planned caesarean birth
- factors affecting the likelihood of emergency caesarean birth during intrapartum care
- procedural aspects of caesarean birth
- care of the baby born by caesarean birth
- pregnancy and childbirth after caesarean birth
Who is it for?
- Healthcare professionals
- Pregnant women and pregnant people, their families and carers
Is this guideline up to date?
October 2021: We checked this guideline and are updating the recommendations on morbidly adherent placenta. For more information, see the surveillance decision. See the guideline in development page for progress on the update.
Guideline development process
This guideline updates and replaces NICE guideline CG132 (November 2011).
This guideline was previously called caesarean section.
The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian.
All problems (adverse events) related to a medicine or medical device used for treatment or in a procedure should be reported to the Medicines and Healthcare products Regulatory Agency using the Yellow Card Scheme.
Local commissioners and providers of healthcare have a responsibility to enable the guideline to be applied when individual professionals and people using services wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with complying with those duties.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.