Who needs a C-section?

C-sections are an increasingly common way to give birth worldwide, but they are generally only recommended when they’re considered the safest way for a baby to be born. However, many medical complications in pregnancy and birth can make a C-section necessary.

Women who experience complications during pregnancy

Many women who deliver by C-section know that it’s going to be necessary long before they go into labor, based on complications that come up during pregnancy. These complications include:

  • A large baby: Whether because of some underlying condition – prenatal diabetes, for example, can increase the chance of a very large baby – or just by chance, sometimes it becomes clear that the baby is too large to safely deliver vaginally. However, a trial of labor is generally attempted, and most large babies are able to be delivered vaginally
  • Uterine scarring: Women who have had more than two C-sections are at an increased risk for uterine rupture, making labor unsafe.
  • Multiples or the baby’s position: Certain types of twins may sometimes be delivered vaginally, but it’s not safe for multiples of more than two to be delivered vaginally.
  • Single babies in the breech position are also often most safely delivered through C-sections. Babies lying sideways, in what is called a transverse lie, are also delivered via C-section to avoid head entrapment and fetal distress. You can, however, talk to your doctor about an External Cephalic Version, a procedure in which they rotate the baby’s head into the right position.
  • Placenta previa: If the placenta is attached in the wrong place, it can cover the cervix and block the baby’s exit
  • Infection: Women suffering infections, like active herpes outbreaks, may be recommended C-sections so their babies are not exposed to infection during birth, though women with herpes may be given medicine to prevent outbreaks starting at 36 weeks. 
  • Other underlying conditions like heart failure, history of strokes, or malformation of blood vessels might make a person a poor candidate for a vaginal delivery

Women who experience complications during birth

It would be wonderful if every woman who was going to deliver her baby through a C-section could know it was going to happen ahead of time, so that she could prepare and research and be ready. Unfortunately, there are certain complications that aren’t generally detectable until labor is already underway. These last-minute C-sections are often called “emergency C-sections,” even if they’re fairly routine ways of dealing with the not-entirely-uncommon complications that sometimes come up during pregnancy. Complications that might mean it’s safest to switch from a planned vaginal birth to a C-section once labor has already started include:

  • Failure to progress: If, by the second stage of labor, labor is moving too slowly or has stopped, doctors may often order a C-section. This could be due to either the cervix not dilating quickly enough, or the baby remaining in the breech position
  • Fetal intolerance: This includes problems with the umbilical cord (like if it’s compressed or wrapped around), placenta, or anything that causes the baby to receive less oxygen than it should. These are often considered emergency C-sections.
  • Other problems that may cause excessive bleeding and be dangerous for both mom and baby

  • “Treatments & Procedures: Cesarian birth (C-section).” ClevelandClinic. Cleveland Clinic. copyright 1995-2011. Web.
  • “Medical reasons for a c-section.” marchofdimes. March of Dimes. June 2013. Web.
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