Need for caesarean section in some breeds approaches 100% and in those breeds (brachycephalics, Scottish terriers and many others) an elective caesarean section is planned. In addition, caesarean section is often also planned in bitches carrying high risk pregnancies. High risk pregnancies are those pregnancies; of large litters (11 particularly in the Boerboel breed), in large breeds carrying singleton or two pup litters, bitches with a history of dystocia and puppy losses and bitches that delivered a litter via caesarean section in their previous pregnancy.

Although properly planned caesarean sections result in good outcome in any breed, caesarean section should best be avoided in bitches that do not really require a caesarean section because a caesarean section in the current pregnancy may increase the need for a caesarean section in the next pregnancy.