A cesarean section, or C-section, involves delivering a baby surgically. Primarily, a C-section is used to protect the health of the mother and baby. Medical innovations have made the procedure much safer and with this advent, the rate of cesarean deliveries has increased tremendously. The decision to have a C-section is not a light one, and both mother and obstetrician must make this decision together, carefully weighing the risks and advantages of surgery. Here’s a look at the reasons cesarean section might be necessary.
Failure to Progress
The most common reason for a C-section is when labor doesn't progress into delivery as it should. This may occur because the cervix isn’t dilating or the uterine contractions aren’t strong enough. A labor that goes on too long can lead to maternal weakness and fetal distress, so your doctor will likely suggest a C-section before it gets to that point.
Fetal Distress
Fetal distress, which can also arise from other issues, is another common reason to perform a C-section. Some babies can’t safely tolerate strong contractions, which will be reflected in a racing fetal heart rate -- fetal monitoring generally occurs throughout labor. When it becomes cause for concern, the obstetrician must decide if the risks posed by a cesarean outweigh the risks of extended labor and fetal distress by delivery vaginally.
Previous Cesarean Delivery
Many women who’ve had a C-section once wind up having to deliver through C-section for all future pregnancies, particularly if the risk factors meriting the initial C-section remains an issue. Although, some women choose to try to deliver vaginally following a C-section (VBAC). This is most successful for women who’ve only had one cesarean delivery. Doctor and mother must agree to a trial of labor after cesarean (TOLAC), which means the team will attempt to deliver vaginally but a cesarean may still be necessary. About half of these VBAC births are performed vaginally. There are different types of C-sections, the most common being a low transverse C-Section, which is also that most likely to result in successful VBAC.
Induction Complications
Despite a developing fear among experts that cesarean sections are used too frequently, there are several other, less common reasons a delivery team might choose cesarean over vaginal delivery. Unfortunately, with an increased in induced labor using pharmaceutical interventions, particularly Pitocin (oxytocin), the number of C-sections seems to be rising. Pitocin often causes complications with labor that ultimately result in a Cesarean being performed.
Maternal and Fetal Complications
In some instances, maternal complications -- pre-existing, planned, or spontaneously developed -- make a cesarean delivery a much safer option, for mother and child. Cephalopelvic distortion is a relatively uncommon condition characterized by a baby's head being too large to fit through the mother's pelvis.
Venereal or other diseases can be another reason for a C-Section. Herpes, for example, is a condition that can be contracted by the newborn through a vaginal birth. Doctors try to prevent the transfer of contractible diseases by performing a surgical delivery. Women who’ve previously undergone certain types of surgeries, such as for fibroid removal, are also likely candidates for a C-section.
When the baby is in a unusual or difficult position, a C-section is a likely alternative to prevent natal complications. For example, a baby in breech position, with the umbilical cord around its neck, or otherwise misplaced, may be delivered most safely surgically. A C-section is also generally preferable in cases like placenta previa, which is a life-threatening condition that results in heavy bleeding, affecting both mother and baby. The mother can go into shock, and the baby may not get enough oxygen.
Every pregnancy, labor, and delivery are different. If you’re concerned about the need for a cesarean section, talk to your obstetrician beforehand so you know what to expect.
