Every woman wants to have a short labor and a quick delivery that is free of complications. They want to have minor contractions, as little pushing as possible, and end with a beautiful, healthy baby in her arms. However, despite these desires, and while it may happen for some women, labor and delivery doesn’t always work out this way.
There are cases when a cesarean section, or a C-section, are necessary. In fact, it is estimated that approximately 30% of all babies who are born in the United States are delivered via a C-section. Given these statistics, even if a woman dreams of delivering their bouncing baby boy or girl naturally, it is wise to know what is involved with having a C-section because there is always a chance that one will be necessary.
I assumed that I was going to have a vaginal birth. However, deep down inside, I think I always knew that my babies were going to be born via C-section. I don’t know why, call it a hunch, I guess. And, low and behold, I was correct. My first baby boy was born via an emergency C-section and my second was born via a planned section.
To ease any fears that women may be having about a C-section, or to spare other women of the shock of finding out that they need to have one, here’s a look at some of the reasons why cesarean sections are performed.
15 Planned and Unplanned Cesareans
Whether you find out months before your due date, or you are in the midst of delivery and discover that you are going to be wheeled into an operating room to delivery via an emergency C-section, it’s can be a little jarring to learn that you are going to need to have a major surgery to deliver your baby.
Rest assured that whatever the reason is, either planned or unplanned, your doctor has the best interest of you and your baby in mind. C-sections can save your life, the life of your baby and can ensure that the end result of your pregnancy is a happy, healthy baby and mama. After all, that is all anyone wants at the end of a pregnancy – including your doctor.
So, with that in mind, do remember that your doctor won’t suggest a C-section unless it is absolutely necessary. He or she truly does have your best interest in mind.
14 Improper Positioning
If your baby is not in the correct delivery position, your doctor will likely suggest that you deliver via a C-section.
During delivery, your baby has to pass through your pelvic bones in order to reach the vaginal opening. The easiest way for a baby to pass through the birth canal is with her head down and her body facing toward the mother’s back, or in the occiput anterior (OA) position.
If your baby is in any other position, such as breech (her bottom is facing down instead of her head,) occiput posterior (her head is down, but she is facing your front and not your back,) or transverse (the baby is positioned sideways,) your doctor will more than likely recommend a C-section.
It is unsafe for the baby to pass through the birth canal in the breech and the transverse positions, and it is possible, but more difficult in the occiput posterior position. Delivering vaginally if your baby is in the wrong condition could lead to serious complications for you and her.
13 Decreased Blood Supply to the Placenta
The placenta is your baby’s life support while in utero. This organ (which is only found in the womb of pregnant women and develops upon becoming pregnant – pretty cool, right?) is responsible for circulating oxygen through your baby’s bloodstream, removes carbon dioxide from his bloodstream, passes nutrients to the baby and removes waste from the baby so that the mom can dispose of it.
If there is an inadequate supply of blood to the placenta, it can cause major complications for mama and baby. The baby may not be getting the proper nutrients, his blood will not be able to oxygenate and carbon dioxide remain in his bloodstream. Likewise, waste will remain in your baby. For that reason, if the placenta is compromised by poor blood supply, you will need to have a C-section, and may deliver prematurely.
12 A Large Baby
If your baby is estimated to weigh more than 9 pounds at birth, your doctor may recommend having a C-section.
In order for your baby to be born vaginally, she must pass through your pelvic bones and reach the vaginal opening. Your birth canal is only so big, so the bigger your baby is, the harder it will be for your little (or big) one to pass through the canal successfully. A bigger baby could lead to broken pelvic bones, a severe perineal tear, and could possibly cause serious bleeding.
To avoid such complications, a larger baby may need to be delivered via C-section.
11 You have a Pre-Existing Health Condition
If the mother has a pre-existing health condition, a C-section may be required.
Some health conditions could become aggravated via a vaginal delivery, or could put you and your baby in danger. For example, if you have heart disease, the stress of labor and delivery worsen your condition and lead to serious problems for you and your little one.
Or, if you have a high viral load, which often happens with HIV or hepatitis C, and the condition is not under control, you and your baby could be at harm during a vaginal delivery.
10 You Have Placenta Previa
If you have been diagnosed with placenta previa late in your second trimester or in your third trimester, you will likely have to have a C-section.
Placenta previa is a condition in which the placenta is attached low in the uterus and blocks some or all of the cervix, or the opening of the birth canal. Because the placenta is obstructing your baby’s bath to the cervix, he cannot safely exit. For this reason, a C-section will have to be performed to safely remove the baby from your womb.
This condition isn't life-threatening to you or your baby, so if you have this condition don't worry, your doctor will monitor the pregnancy for any new developments.
9 Placental Abruption
Placental abruption occurs when the placenta separates from the uterine lining. In most cases, this condition develops in the third trimester.
The separation of the placenta can cause serious bleeding for mom, and can interfere with oxygen getting to the baby. Depending on the severity of placental abruption, a C-section may be required.
If this condition isn't treated, it can cause serious complications for the mother and the baby. If you're in your last trimester and you have these symptoms, call your doctor immediately: vaginal bleeding, abdominal pain, back pain, uterine tenderness, or rapid uterine contractions.
8 A Cord Prolapse
This situation is extremely rare, but it can happen, and when it does, an emergency C-section must be performed.
When the cord prolapses, it protrudes from the vagina before the baby is born. When the uterus contracts, it squeezes on the cord and diminishes the blood flow to the baby. Lack of blood to the baby could cause brain damage and other serious complications.
The cord doesn't always have to be coming out of the womb, it can be bent and putting pressure on the cord inside the womb. In any of these cases, your doctor will be monitoring your pregnancy and performing ultrasounds to make sure everything is progressing along the way they're supposed to.
7 Fetal Distress
Should your baby be in distress, for any reason, you will have to have a C-section.
The most common cause of fetal distress is a lack of oxygen while in the womb. My first-born, for example, went into severe distress after 72 hours of labor. There wasn’t any fluid left in the womb and he was pressing on the cord. As a result, he wasn’t receiving enough oxygen and off I went to the operating room to have an emergency C-section.
If there is a lack of oxygen to the baby, fetal monitoring will detect it and your doctors will likely perform an emergency C-section after trying to resolve the distress.
6 Labor Not Progressing
If your labor is not progressing, a C-section may be necessary. For example, if the cervix isn’t dilated completely, or labor has slowed down or stopped, you will likely have to have a cesarean.
You doctors will try methods to progress your labor, such as providing you with medications, or trying to sweep your membranes; however, if these methods fail, you could be looking at a C-section delivery. The reason? – Chances are if your labor isn’t progressing on its own or with assistance, it isn’t going to progress at all.
In this situation, the only way to get the baby out is via a C-section. This was another reason why I was unable to have a vaginal delivery; my labor did not progress, despite induction. It was because of the lack of progression that caused my baby to go into distress.
5 A Repeat Cesarean
Women who have already had a cesarean section often deliver via C-section for any following pregnancies.
Though 90% of women who have had a previous C-section are able to have a vaginal birth after cesarean for their succeeding pregnancies (called a VBAC,) there are risks involved. The largest risk is involved is a uterine rupture, which occurs in .2 to 1.5% of VBAC deliveries. If this happens, the mother’s life could be in serious danger.
If you have had a previous cesarean section and you would like to try having a VBAC for a later delivery, you will need to consult with your doctor. There are certain criteria that must be met in order for your health care provider to approve a VBAC. Remember, your safety and the safety of the baby is paramount.
4 A Case of Active Genital Herpes
If the mother has genital herpes and it is active at the time of labor, a C-section will be necessary. Your doctor will be able to tell if the disease is active by either detecting lesions in the vaginal area, or by performing a culture that returns positive.
Why is a C-section necessary in the case of active herpes? – Because there is a risk that your baby could be exposed to and contract the virus while passing through the birth canal if there is an outbreak of the disease. If a newborn contracts herpes, the results can be devastating.
The disease could affect the baby’s skin, eyes and/or mouth. Sores will develop soon after delivery and require prompt medical treatment to avoid a more severe form of herpes from developing. In more extreme cases, the central nervous system could be affected or multiple organs could be impacted.
3 A Diagnosis of Preeclampsia
If you have been diagnosed with preeclampsia, there is a chance that you will have to deliver via a C-section.
Preeclampsia is a condition that causes high blood pressure during pregnancy. If the blood pressure becomes too high, it could prevent the placenta from transferring the proper amount of blood that your baby needs, as well as decrease the oxygen flow to the baby.
Do note that not all pregnancy women who are diagnosed with preeclampsia have to deliver via a C-section. Only those who have a severe case will be required to have a cesarean; in milder cases, a successful vaginal delivery can occur. If you are diagnosed with preeclampsia, your doctor will advise you of your condition and your delivery options.
2 Birth Defects
If your baby has been diagnosed with a birth defect while in utero, your chances of delivering through a C-section are greater.
Birth defects can make it difficult for your baby to successfully pass through the birth canal. In order to avoid further complications for your baby, and for you, your doctor may suggest a C-section delivery. If your baby has been diagnosed with spina bifida while in the womb, you will more than likely not be permitted to delivery vaginally.
Spina bifida is a birth defect that is known as a neural tube defect. It happens when the bones of the spine, or the vertebrae, don’t form properly around part of the baby’s spinal cord. A vaginal birth could result in further damage to the baby’s spinal cord.
1 Multiple Births
If you are carrying more than one baby, a C-section delivery may be required.
If you are expecting twins, a vaginal birth may be possible, but it depends on the position of the babies, their weights and their gestational age. If you are pregnant with more than two babies, your chances of delivering vaginally are slim. Why? – There are several reasons. One reason is because the babies may need to be delivered before they have fully developed, due to a lack of space in your uterus.
Another reason may be because of the size and position of your babies. Lastly, having more than two babies vaginally could be extreme stress on you, the mother, and could increase the chances of excessive perineal tearing and hemorrhaging, among other issues.
If you are pregnant with multiples, your doctor will advise you on what the safest delivery method is for you and your babies.