Nothing incites heated controversy quite like the topics of pregnancy and childbirth. And for some reason, society harbors a real hate-on for C-sections. We're not exactly clear what the ruckus is about. There’s no shame in the procedure - in fact, it is thanks to this life-saving surgery that pregnancy and childbirth have become less dangerous for so many more women. Once upon a time, it was pretty much a coin toss that determined whether a woman and baby would survive childbirth.
Let’s get something straight though - we’re not talking about elective C-sections here. The ones scheduled well in advance because a woman prefers her child be born on the date of her choosing or because she’s simply too posh to push. We’re talking about C-sections that save the lives of mothers and babies or at the very least stave off further complications.
Of course, emergency C-sections do come with their own set of potential risks - especially compared to when they are planned. But when life hangs in the balance and decisions have to be made on the fly, it’s for the best to err on the side of caution. Who wants to take a chance when it comes to the lives of mother and infant?
So let’s put an end to this futile argument once and for all. Every childbirth situation is unique and every pregnant woman is different. Here are 15 times a C-section is the best option.
15 Life And Death Sentences
A C-section can be a literal life saver for an expectant mother suffering from a chronic condition. While in the past, women who had diabetes or heart disease were advised against giving birth due to possible fatal complications (remember Julia Roberts’ character in the 1989 tearjerker Steel Magnolias?), there is now much less risk associated with this thanks to C-section delivery.
Pregnancy places stress on a woman’s heart and circulation systems and when she pushes during childbirth, her blood flow and blood pressure levels change. As soon as the baby is born, blood flow immediately decreases through her uterus which can place some stress on her heart. But thanks to the advent of the successful C-section, childbirth is no longer considered a death sentence (or even a dangerous journey) for women suffering from chronic conditions.
Of course, special precautions are advised. While all pregnant women are encouraged to attend their prenatal appointments, they are especially important for an expectant mother who is deemed high-risk.
14 History Repeats Itself
Women who have undergone a previous C-section sometimes push (pun intended) for a procedure known as VBAC (Vaginal Birth After Cesarean) for subsequent deliveries. But unfortunately not all women are candidates for this procedure.
A repeat C-section may be recommended for a variety of reasons including:
- Her previous incision was a vertical cut as opposed to horizontal.
- She suffered a uterine rupture during her previous labor.
- She is expecting twins.
- She is aged 40 or older.
- Placenta previa has been detected.
- The baby is in a breech position.
- Her labor will most likely require induction.
There are many benefits to undergoing a repeat C-section. For one, it makes it easier in terms of planning for childcare and/or time off work. A woman may feel less anxious and actually more in control of the birthing process. She also knows what to expect of the procedure and how to promote the healing process.
13 Past Losses
Stillbirth delivery, while not frequent is still an awful reality for some women. There are any number of reasons for why it can happen. And depending on the contributing factors in the past, doctors may prefer to play it safe when it comes to an expectant mother’s future deliveries.
Especially in cases where stillbirth remains unexplained, healthcare professionals may prefer to induce labor which increases the chance for C-section. Or it may be decided to cut out the middle step and simply schedule a C-section to begin with.
Having to endure the death of a baby during childbirth is difficult enough to get through. Scheduling a C-section for subsequent deliveries may help reassure a pregnant woman and allow her to feel more in control of labor and delivery. As her due date draws near, she may become anxious that history will repeat itself - which is where a C-section comes in handy. It may be the best way to ease her concerns about a safe and successful delivery this time around.
12 Medically Speaking
Letting nature take its course is for the best . . . except sometimes when it’s not. In certain labor and delivery situations, doctors may need to have a team assembled and prepared for the birth - especially if life-saving procedures and surgeries are required.
In cases where babies have already been diagnosed with birth defects and/or disorders from undergoing tests in utero, a scheduled C-section may be the safest option in order to reduce chances of further complications.
Any number of other fetal medical concerns can crop up prior to or during labor and delivery where the healthcare provider may feel that a C-section is a necessity. Common fetal issues that often lead to C-section surgery include oxygen deprivation, a slow or irregular heartbeat, even a baby pooping in utero. It may sound silly but meconium (fetal poop) can be highly toxic if ingested.
When an unborn baby’s health is in question, time is of the essence. Rather than attempting to correct the problem, the safer option may be to birth the baby ASAP via C-section.
11 Son Of A Breech
Experts and couch critics alike are happy to add their two cents to the heated debate about babies in breech position and C-sections. But the bottom line is this: stillbirth rates are lower for breech babies born via C-section than by vaginal delivery.
Doctors can sometimes turn a breech baby so the mother can go on to have a successful vaginal delivery . . . but not always. The ECV (External Cephalic Version) procedure is also an option where the baby is lifted and turned into proper birthing position. If a viable choice, doctors will attempt it when a fetus reaches the 36 week mark so that chances are low of baby changing position again or being born too prematurely.
In the U.S., the majority of breech babies are born via C-section. There are several reasons behind this practice including that many medical professionals are just not extensively trained in vaginal delivery for breech presentation. Also, labor and delivery for a breech baby can go sour quickly. In 1000 vaginally-born breech babies, 1.6 will die - so why take the risk?
10 Stifle The Trauma
Childbirth may be a perfectly normal and common part of life. But because labor and delivery rarely go according to plan, it can sometimes end up being a tumultuous and even scary experience for some women. They may find themselves dealing with an unexpected situation, an abusive or negligent healthcare provider or even the belief that their baby is in danger. Lack of care and support or feelings of powerlessness can also turn childbirth into a traumatic experience.
Even if all ends well, lingering effects from a frightening childbirth incident can take on a form of PTSD. It is not unheard of for some women to suffer from many symptoms including: insomnia, nightmares, flashbacks, anxiety and panic attacks. Entering the realm of motherhood is difficult as is . . . now imagine trying to care for a newborn while also suffering the effects of PTSD?!
In cases like these, it makes sense to do whatever it takes to ensure an expectant mother undergoes a much different, positive and controlled experience in the future. Childbirth is difficult if a woman is severely stressed and/or emotionally damaged. She and her healthcare provider may feel that undergoing a C-section is the best course of action.
9 That Baby Is Yuge!
Big babies come with their own set of possible complications where labor and delivery are concerned. They have an increased chance of getting stuck during a vaginal birth (known as shoulder dystocia) which can lead to permanent nerve injury as well as oxygen deprivation. Mothers are also at higher risk of suffering extreme tearing and/or hemorrhage when delivering a larger than average baby.
When a baby is diagnosed as larger than average, induction is sometimes suggested so that baby can be born before growing any bigger. However, when induction occurs, the chances of undergoing a C-section increase.
Expectant mothers suffering from gestational diabetes tend to have larger than average babies. This is why it is important for women to manage their condition as best they can through diet, exercise and prescribed medications.
How big is too big is up for debate. While some feel a baby clocking in at eight pounds 13 ounces or more is the criteria, others feel nine pounds 15 ounces (or more) at birth is the benchmark. Babies weighing 11 pounds (or more) at birth are considered “extremely” large!
8 Infection: Cause For Section
If an expectant mother has an infection, she may unknowingly pass it on to her baby during delivery. This is why it is imperative that women attend all checkups. Many infections can be treated prior to childbirth which minimize the risk of baby contracting them as well.
However, two specific infections have no guaranteed treatment or cure. HIV and herpes, while manageable for life, can infect a newborn during childbirth which is why in most cases, undergoing a C-section is recommended.
In terms of HIV, infants can become infected during pregnancy, childbirth and even sometimes through breastfeeding. Certain anti-viral medications can reduce the risk of a baby contracting the infection in utero. Vaginal delivery may even be an option if the expectant mother has only low levels of the virus in her blood stream. But most often, a C-section is the safer alternative.
An expectant mother suffering from active herpes lesions will be urged to undergo a C-section to prevent her baby from being infected during a vaginal delivery. Herpes contraction by a newborn can lead to serious health issues including: Central Nervous System disease, organ failure and developmental problems.
7 More Than One
C-sections are not automatic just because a woman is expecting twins or even triplets. But the odds of having one do increase with each extra fetus she is carrying. This is because the chance of experiencing complications during labor and delivery are higher. When more than one baby is expected, it makes sense to give birth in a hospital with the help of skilled professionals experienced in the delivery of multiples.
Delivery method basically depends on how the babies are positioned within the uterus. Typically, expectant mothers are encouraged to try for a vaginal birth as long as babies are situated with heads down. A C-section may be suggested if one of the babies is not head-down, if babies are sharing an amniotic sac or if there are triplets (or more).
It’s not unheard of for a woman carrying twins to give birth to the first baby vaginally and the second via C-section. In the end, all that matters is that mom and babies are safe and healthy and given the best possible start to their life as a family.
6 Placental Probs
During pregnancy, if a placental issue is diagnosed, undergoing a C-section may be the safest course of action. The most common placental issues include:
- Placenta Previa - This means that her placenta is situated in the lower part of her uterus. It can increase the chances of baby being in an abnormal birthing position as well as result in hemorrhage during delivery.
- Placenta Accreta - This further complication occurs in five to 10% of women suffering from placenta previa. It occurs when the placental tissue grows too deeply within the womb. As a result, there may be difficulty in the placenta separating from the uterus wall during childbirth.
- Placental Abruption - This serious condition happens when the placenta separates (either partially or completely) from the uterine wall before birth. If this occurs, a baby may not receive sufficient oxygen or nutrients from the womb.
- Placental Insufficiency - This complication is rare as it only affects one out of 300 pregnancies. Yet it can be life-threatening if not detected and treated. It occurs when there is inadequate blood flow to the placenta during pregnancy. As a result, a fetus may not receive the nutrients and oxygen required to grow and thrive.
5 Moving Right Along
Sometimes no matter what a woman and her medical team do, labor fails to progress. C-sections are one of several alternatives that are used to solve this dilemma. They tend to be a favorite because they boast a high success rate in terms of preventing more serious complications.
Prolonged labor is defined as labor lasting 20 plus hours in first time moms and 14 plus hours for mothers who have given birth before. When labor is prolonged during the first stage of childbirth, it may be draining but is generally not cause for worry. However, when occurring during the active phase of childbirth, this can be dangerous.Reasons for experiencing a prolonged labor vary and include:
- The baby is too large.
- The birth canal and/or woman's pelvis are too small.
- She is carrying multiples.
- Baby is in an awkward birthing position.
- A woman is experiencing weak uterine contractions.
- There may be psychological factors at play such as fear, worry or stress.
4 Clamp It Up
Formerly called toxemia, preeclampsia is a potentially fatal condition when a pregnant woman’s placenta doesn’t function properly. It is generally marked by a sudden spike in blood pressure and usually occurs later within a pregnancy - though not always. There is no cure - once it is diagnosed, it is generally recommended that a baby be born immediately. For expectant mothers who have not yet reached the 30 week mark in their pregnancy, a C-section will be their safest option.
If left untreated, preeclampsia can lead to further dangerous complications such as:
- A decreased blood flow to the placenta.
- Placental abruption (where the placenta separates from the uterine wall before delivery).
- Destruction of blood cells.
- Organ damage.
- Eclampsia which includes all the above complications as well as maternal seizures.
The reasons behind this life-threatening condition are still up for debate. Some experts believe preeclampsia is caused by poor nutrition, high levels of body fat, insufficient blood flow to the uterus as well as genetics.
3 Blood Relations
Bleeding during childbirth comes with the territory and is to be expected. Most often, normal bleeding tapers and stops when the baby descends through the birth canal. However, if during childbirth a woman experiences bleeding to the point of hemorrhage, the decision may be made for her to undergo an emergency C-section.
There are many reasons a woman may suffer heavy blood loss during labor and delivery which can prove dangerous. They include:
- Placental Abruption - When the placenta separates from the uterine wall before the baby is born.
- Placenta Previa (also referred to as low-lying placenta) - This occurs when the placenta covers the cervix.
- Uterine Rupture - This uncommon occurrence happens when the scar from a previous C-section tears open.
- Cervical Tear - While not as common as a vaginal or perineum tear, cervical tears can still sometimes occur.
- Assisted Birth - Bleeding can become exacerbated when instruments are used such as forceps or a vacuum.
2 Pull The Cord
Terrified of giving birth yet? If not - then here’s yet another thing that can go disastrously wrong when it comes to labor and delivery and it involves the umbilical cord. This literal lifeline connects mother and baby throughout a pregnancy - delivering vitamins, oxygen and even blood from mother to infant. And if all goes according to plan, a baby is born, the cord is cut and baby breathes on their own.
But sometimes, Mother Nature throws a monkey wrench into the mix and umbilical cord issues arise. They include:
- Umbilical Cord Prolapse - This is when the cord drops through a woman’s open cervix during delivery. The cord can get trapped or even wrapped around the baby which can lead to complications, sometimes even stillbirth.
- Nuchal Cord - This occurs when the cord gets wrapped around baby’s neck. For some mysterious reason, it most commonly happens in male babies.
- Cord Knots - As long as they remain loose and are carefully monitored, there is generally no need for worry. But during childbirth, there is the possibility of them tightening.
1 Risk Of Rupture
For women at risk of suffering a uterine rupture during a VBAC, a C-section may be the better option. While the occurrence is rare, it does happen from time to time and may result in serious complications for both mother and baby.
Basically, the rupture occurs when the uterine wall separates at the site of a previous C-section incision. Fortunately, most C-section incisions are low-transverse (horizontal) making it less likely to rupture during future pregnancies and deliveries. In fact, odds are stacked against a uterine rupture from happening at all. Experts in the field state that less than one percent of women attempting a VBAC will suffer a rupture.
It should be noted that there have been instances where an expectant mother has suffered a uterine rupture without ever having undergone a C-section before! The reasons behind such an unlikely situation include: having weakened uterine muscles (probably due to prior pregnancies); going overboard on induction techniques; having undergone a surgical procedure on the uterus in the past; and/or due to forceps usage.