Elective Caesareans in Dogs
- veterinaryvoicesuk
- 3 minutes ago
- 7 min read
Elective Caesareans in Dogs: When Responsible Clinical Planning Risks Becoming a Substitute for Responsible Breeding
Would you buy a puppy from a breeder whose dogs routinely required elective Caesarean sections to give birth?
It is a deliberately uncomfortable question, because it sits at the intersection of veterinary responsibility, breeder responsibility, genetics, animal welfare and the immediate needs of the individual patient.
At first glance, the answer may appear straightforward. Dogs should, wherever reasonably possible, be capable of mating, carrying a pregnancy and giving birth without surgical assistance. If we routinely use veterinary intervention to enable animals with conformations that prevent normal reproduction to continue producing offspring, there is an obvious danger that medicine ceases simply to treat the consequences of poor breeding and begins facilitating their continuation.
That is reflected in a 2017 article that quoted:
‘Why do [caesareans] make me depressed and angry? Because they make me complicit. They drag me into the cycle of suffering and force me to participate,” says Nick Marsh. I am faced with a suffering animal, yet I know if I do what I have to do, I am helping perpetuate the pain and misery these anatomical disasters cause.”’
But clinical reality is more nuanced.
There is an important difference between a breeder deliberately producing dogs whose anatomy makes natural birth intrinsically difficult, with a planned Caesarean regarded as simply another stage of production, and an experienced, welfare-conscious breeder working closely with their veterinary team who encounters a particular pregnancy in which a carefully timed Caesarean is judged safer for the dam and puppies.
Failing to distinguish between those circumstances risks replacing one overly simplistic position with another.
Dystocia is not a rare problem in veterinary practice, prevalence data depends on source however, in a UK study examining 701 canine dystocia cases across 50 first-opinion emergency clinics found that 48.6% of affected bitches underwent Caesarean section.
Brachycephalic bitches presenting with dystocia had greater odds of undergoing Caesarean section compared with non-brachycephalic dogs. In the same study, 12 of the 701 bitches presenting with dystocia — 1.7% — died during emergency care.
The UK Animal Welfare Committee's opinion on specialised canine reproductive practices reports Caesarean rates of more than 80% in Boston Terriers, English Bulldogs and French Bulldogs. It also notes evidence that Caesareans are required in more than 80% of English Bulldogs, French Bulldogs and Boston Terriers experiencing dystocia. Almost 40% of multiparous bitches presenting with dystocia in one large UK dataset had previously experienced dystocia or Caesarean section.
International data point in the same direction. Danish Kennel Club data cited in the material reviewed found that the overall prevalence of Caesarean section increased from 12.7% to 15.5% between 2013 and 2022, but with enormous breed variation: approximately 4.7% in Poodles compared with 80% in English Bulldogs.
When a surgical procedure becomes exceptionally common within a breed, we should ask whether we are still treating individual obstetric complications or compensating for a population-level problem that humans have created through selection.
This tension was reflected strongly in an informal poll conducted within the Veterinary Voices UK Closed Discussion Group.
Veterinary surgeons and Registered Veterinary Nurses (RVNs) were asked whether they would feel comfortable performing, or in the case of RVNs supporting and managing the General Anaesthetic (GA) and care of, elective Caesarean sections, with the question specifically framed around providing them as a regular service for dogs presumed unable to whelp naturally because of their conformation or previous history.
Only 1% indicated that they were comfortable doing so. 88% said they were not, while 11% indicated that they would perform the procedure if an ovariectomy or ovariohysterectomy was carried out at the same time (presumably as a reflection of the understanding that we have a responsibility to relive pain and suffering in that patient whilst feeling ethically conflicted about the possibly of that dog being bred from again).
This was an informal professional poll, not a controlled scientific survey, so its percentages should not be extrapolated to the UK veterinary profession as a whole or taken as robust evidence. Nevertheless, the strength of the response illustrates the ethical discomfort experienced by many veterinary professionals.
That discomfort is also visible in published research.
A survey of 83 veterinarians, predominantly from Europe and working with small-animal reproduction, found heterogeneous views on reproductive interventions. Approximately half considered elective Caesarean sections unethical, while more than 80% reported feeling at least sometimes compromised by ethical conflicts associated with reproductive practice.
The concern, therefore, is not simply about performing an operation. It is about what that operation potentially enables.
An elective Caesarean can protect welfare in the immediate patient. Emergency dystocia can be dangerous for both dam and puppies. Published literature recognises that elective Caesarean section may reduce some of those risks in appropriately selected high-risk pregnancies. The difficulty arises when the availability of a relatively predictable surgical solution makes it possible to repeatedly breed animals that are themselves unable to reproduce normally.
As one of the papers reviewed for this article puts it, elective Caesareans can be a reasonable alternative for bitches at high risk because of factors including litter size, age, parity, previous Caesarean and breed. Yet uncritical use may also facilitate continued breeding from dogs unable to give birth naturally, perpetuating traits associated with dystocia.
There is a profound ethical difference between using a Caesarean to manage an individual obstetric problem and designing a breeding programme around the assumption that Caesareans will be required.
Other veterinary organisations policy similarly states that Caesarean sections cannot simply be regarded as a normal procedure in dogs and that veterinary assessment should determine whether surgery is appropriate in the individual clinical situation.
However, not every planned Caesarean represents irresponsible breeding. Even carefully selected, functionally healthy dogs can develop complications. A singleton pregnancy is an obvious example. Small litter size can contribute to problems surrounding initiation of parturition and fetal size.
Veterinary Voices UK contributors repeatedly raised precisely these distinctions.
One described circumstances in which progesterone monitoring had established ovulation accurately and a singleton pregnancy had been identified, arguing that this was fundamentally different from breeding a bitch whose conformation itself made Caesarean delivery predictable. Another emphasised considering “the number of puppies, history and condition of the bitch, availability of other provisions if you say no, attitude of the breeder” and other contextual factors.
Another practitioner described a reproductive service built around progesterone confirmation, careful communication, established vet-client relationships and deliberate selection of appropriate clients and patients.
Those comments identify something that can disappear when this debate is reduced to “elective Caesareans: yes or no”.
An invested, responsible breeder should know their bitch extraordinarily well. They should know her health history and reproductive history. Appropriate health screening should have preceded mating. They should understand the health of the proposed sire and relevant inherited risks within both lines. Pregnancy should be appropriately monitored and veterinary advice sought early rather than only after an emergency develops.
Where clinically appropriate, reproductive management may include establishing ovulation timing through progesterone testing, appropriate ultrasonography and close observation as parturition approaches.
That breeder is not ethically equivalent to somebody repeatedly breeding dogs with extreme conformation because puppies are profitable, accepting from the outset that the bitch is unlikely to whelp naturally and treating surgery as a routine production cost.
Indeed, contributors to the Veterinary Voices UK discussion articulated exactly this dilemma: clinicians may dislike the wider breeding practice while simultaneously recognising that, once a heavily pregnant bitch is standing in front of them, they have an immediate responsibility to that individual animal. Some worried that refusing elective procedures indiscriminately could simply result in those dogs presenting later in greater distress or being taken elsewhere.
That is not an endorsement of breeding dogs incapable of natural parturition. It is a recognition of the difference between preventing tomorrow's welfare problem and treating today's patient.
Nuance, however, cannot become an excuse for avoiding uncomfortable conclusions.
Inability to mate or give birth naturally as one of the welfare problems associated with brachycephaly. Animals displaying extremes that negatively affect their health and welfare should not be used for breeding.
If a bitch's anatomy makes natural parturition unlikely, and that anatomy is itself the product of selection for an exaggerated phenotype, repeatedly breeding that dog and planning surgery each time is difficult to defend as responsible breeding.
This is also why reporting matters. The Royal Kennel Club asks veterinary surgeons to report Caesarean sections performed on registered dogs. The data are intended to identify breeding lines potentially transmitting defects, discourage breeding from affected dogs, encourage natural birthing ability and monitor trends in prevalence.
Yet approximately 95% of the reports received by the Royal Kennel Club come from owners, with comparatively few submitted by veterinary surgeons.
That represents a missed opportunity, although adds to the already high burden expected of veterinary professionals.
“Would you perform an elective Caesarean?” produces an emotionally powerful debate, but it may be too crude a question.
More useful questions might be:
Why is this particular bitch expected to need one?
Was the risk created by an unpredictable feature of this pregnancy, or was it foreseeable before mating because of the dog's conformation or reproductive history?
Has everything reasonably possible been done to monitor this pregnancy and establish the safest time and method of delivery?
Is this intervention protecting a particular dam and litter, or facilitating a breeding programme dependent upon surgery?
And, crucially, should this bitch — and dogs carrying the same problematic traits — be bred from again?
Those questions allow veterinary professionals to defend individual animal welfare without normalising reproductive dysfunction.
There is nothing inherently irresponsible about recognising that a Caesarean is the safest option for a particular pregnancy.
Sometimes the most welfare-conscious decision is precisely to intervene before a predictable emergency becomes a catastrophe. A breeder who has invested in appropriate health testing, veterinary relationships, reproductive monitoring and careful observation should not automatically be placed in the same category as someone knowingly reproducing extreme, unhealthy dogs.
But neither should “good breeding management” become a sophisticated means of perpetuating animals whose bodies cannot perform basic biological functions without veterinary assistance.
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