If you're an expectant mother, a vaginal birth is probable. But, according to Childbirth Connection, cesarean births are the most common operating room procedures in the United States.
A cesarean birth, or a C-section, is an operation that makes an incision in a pregnant woman’s belly through to her uterus. Through an opening, the newborn is lifted out, and the baby is officially born. In most cases, the mom-to-be can be awake through the surgery, and spend time with her baby soon after delivery. Dissolving stitches repair the incisions while sutures or staples seal the tissues of the abdomen. The entire procedure takes about an hour. Recovery for a C-section will require about a three-day stay in a hospital.
Roughly, 1 in 3 pregnant women experiences a cesarean birth. If you are a likely candidate for a C-section, it will probably be for one of the 10 following reasons.
10 Cord Prolapse
The umbilical cord is the lifeline to the baby. It’s a vital link that sends nutrients and oxygen to the fetus while carrying away waste.
If the umbilical cord is pushed through the cervix and becomes visible from the vagina before delivery, this is known as a cord prolapse. It is an uncommon complication, occurring in about 1 in every 300 births. However, if it happens, an emergency C-section may be scheduled.
There is a reason why cord prolapse is considered high risk for a vaginal delivery. If the cord precedes the baby, the mother’s contractions can cause intense pressure that can compress the cord. This situation would severely reduce the blood supply, cutting off oxygen to the baby. Needless to say, this can lead to major complications. In some cases, a cord prolapse is classified as an emergency C-section delivery.
9 Placental Problems
The placenta is a flat, circular organ that produces hormones to support the life of a fetus. The major functions are to supply nourishment and oxygen to the fetus and filter waste away from the baby. It grows to the weight of 2-3 pounds.
During the third stage of labor, the mother delivers the placenta. But if there is a problem with the placenta, it can pose a risk for both the baby and the mother. Placental problems include:
- Placenta Previa: the placenta settles in a lower section of the uterus, blocking the opening of the cervix. Sometimes, the placenta partially obstructs the cervix, but if the uterus grows enough to move the placenta away from the opening, a vaginal birth is possible. If the area remains covered, a cesarean section is necessary.
- Placental Abruption: the placenta prematurely detaches from the uterine wall. If severe bleeding is present in the third trimester, and the baby is in trouble, you may need an emergency cesarean birth.
8 Breech Baby
Babies twist, turn, and move all around the womb. In the last few weeks of pregnancy, the living quarters of the uterus becomes cramped. As early as week 32 and as late as week 38, most babies have settled into a head-down position, but some don’t. Around 4% of babies wind up in breech positions; this means their butts or their feet are positioned down to come out first through the cervix.
There are reasons for wanting to adjust a poorly positioned fetus. For instance, if a baby’s feet are positioned to come out first, there is a chance your baby could become tangled in the umbilical cord. A breech baby can make a vaginal birth difficult, and sometimes impossible.
The chances are good that your infant will be head-down by your estimated due date. Most breech babies re-position before delivery. But if your little one is still primed to come out feet-first, a cesarean section may be necessary.
7 Fetal Distress
The hospital staff needs to stay on top of potential complications so they can quickly address complex situations. This is why a baby is closely monitored during labor and delivery. One common method of monitoring the fetus is through fetal heart rate (FHR) monitoring.
Fetal distress commonly occurs because there is a lack of oxygen going to the baby. If fetal monitoring shows a prolonged abnormal heart rate or signs of inadequate amounts of oxygen, a C-section may be advised to prevent further complications.
6 Slow Labor
Sometimes, a labor fails to progress. This can happen if the cervix does not completely dilate. As a result, labor slows down or stops completely. A slow labor needs to be diagnosed in the second stage of labor after a woman has dilated to at least five centimeters. (A diagnosis in the first stage of labor would be premature as labor usually progresses slowly in this stage.)
Failure to progress can be exhausting and risky. Not only does the mother become emotionally and physically drained, the fetus can become distressed. Slow labor is a reason for 1 in 3 cesarean births.
5 Big Baby & Small Pelvis
When a baby’s head is too big or a woman’s pelvis is too narrow for a baby to descend the birth canal, this is known as cephalopelvic disproportion (CPD). This scenario is rare, occurring in approximately 1 out of 250 births. However, many slow labors have been attributed to CPD.
Once an accurate diagnosis of CPD has been made, a cesarean section is the safest option. The good news is women who have been previously diagnosed with CPD can still give birth vaginally. According to the American Journal of Public Health, 65% of pregnant women who had CPD in earlier pregnancies delivered vaginally in subsequent pregnancies.
If you've gone past your due date, the size of your baby can be a concern. After 41 weeks, a big baby can put a vaginal birth in jeopardy. Your health care professional will keep a watchful eye on your pregnancy, but don’t expect your doctor to induce your labor right away.
Your obstetrician will assume you are more than ready to have your baby, as most women are in the later stages of pregnancy. Although you might be ready, your baby might not be ready for the world. The last few weeks of pregnancy develop the heart, skin, lungs, and other organs your baby needs to survive in the outside world. This is one reason medical professionals sometimes have a wait-and-see attitude, to let nature take its course.
Your doctor will become more concerned after 42 weeks when your pregnancy is more likely to have some risks. One risk is that your baby may be too big to deliver vaginally. This can make labor and delivery longer and more difficult.
If your fetus is estimated to be over 9 lbs, you have a big baby. Your medical team will assess if your baby can safely descend the birth canal. If not, you may be a prime candidate for a C-section.
3 Repeat C-section
Most women who previously had a cesarean section are candidates for a vaginal birth for their next delivery. However, there is a slight risk of uterine rupture for a vaginal birth after cesarean (VBAC). Pregnant women will need to meet certain criteria for a VBAC. This is why some will require a subsequent cesarean birth. A vaginal birth is certainly possible, but these details will need to be discussed with your doctor or your midwife.
There are risks associated with C-sections. While it happens every day, C-sections are in fact invasive surgeries. Discuss your birthing options with your obstetrician or midwife during your next checkup. They can figure out if you may be a candidate for a cesarean birth.
2 Chronic Health Problems
There are a number of reasons why a doctor may recommend a C-section, especially if the mother-to-be suffers from chronic health problems.
- Diabetes: if you are expecting and develop gestational diabetes, your baby may have a large birth weight. This can increase your chances of a cesarean birth.
- Genital herpes: an outbreak of genital herpes can be spread to a baby. To prevent the exposure of this virus, a C-section may be the best option.
- Severe preeclampsia: this condition can occur with high blood pressure. It can hinder the flow of blood and oxygen to the fetus. In some cases, delivery is the only cure. A C-section can be recommended for severe cases of preeclampsia.
In these situations, a cesarean section may be performed to avoid further complications.
1 Twins, Triplets or More
Being pregnant with twins or higher multiples of children doesn’t guarantee that you will have a cesarean section. The majority of twins are born vaginally, but nearly 50% are born through C-section. That number jumps to 90% with triplets. If you are expecting more than one child, your chance of having a cesarean birth is higher.
One factor used to determine if you will have this procedure is how your babies are positioned in the womb. Complications sometimes arise due to the presentation of the fetuses. Upon examination, your doctor or midwife will determine if a cesarean birth is necessary.