Emergency vs. unplanned C-sections

There isn’t always a clear-cut distinction between an emergency C-section and a C-section which is just unplanned, but not technically an emergency. Part of the reason the line is so blurred is because different hospitals and providers have different ways of listing procedures.

Many facilities only list either “planned” or “emergency” C-sections, without any room to describe any births that fall in-between those two descriptions. This can make sense as a way of coding C-sections on paper, but in person, calling some C-sections “emergencies” just because they weren’t planned ahead of time can be more worrying than they need to be. This is especially true for soon-to-be or new parents, whose feelings are already intense. Unplanned C-sections can happen for different reasons, and only some of those reasons are “emergencies” in the traditional sense.

Reasons for unplanned C-sections

Some of the reasons for an unplanned C-section that may qualify as an emergency, and may require an immediate decision and a rush to the operating room, include:

  • Fetal distress: If the baby’s heart rate is low, or the baby is not getting enough oxygen for any reason
  • Placental or uterine issues: Unexpected problems with the placenta or uterus can cause heavy bleeding during labor that can be dangerous to both mother and child.

On the other hand, some of the reasons to have an unexpected C-section once labor has already started aren’t as time-sensitive, and sometimes having a C-section is only one of a few possible solutions to try. These unexpected C-sections, even if they weren’t planned, can happen at a more relaxed pace, with more time to prepare. Some reasons for C-sections like these might be:

  • Slow labor: If, moving into the second stage of labor, labor appears to be slowing down or even stopping, a doctor might offer her the option of delivering through C-section. Alternative options might include waiting and either moving around, changing position, or getting some rest, in the hope the labor might speed up on its own
  • Large baby: Sometimes it appears that the baby is too large for a safe delivery. In this case, the mother might be offered the option of a C-section, or the doctor might wait a little longer to see how labor progresses on its own

Differences between unplanned and emergency C-sections

When the uterus is preterm, sometimes there isn’t room to use a horizontal incision for a C-section, and so a vertical incision is needed to deliver the baby safely. This is the only reason the vertical incision is currently used, since these incisions create an increased risk of uterine rupture during labor in future pregnancy, so women with vertical incisions are generally not considered candidates for later vaginal births after C-sections.

Emergency C-sections are more likely to be performed under general anesthesia so they’re unconscious during the operation, although only if they have not already had an epidural. This is uncommon in planned C-sections. In some facilities, spinal anesthesia is thought to reach moms faster than general, though, and in some cases, regional anesthesia may be the most efficient.

Family members are also less likely to be allowed to join the new mom in the operating room during an emergency C-section.

In the end, there isn’t any kind of rule for determining what makes an emergency C-section instead of just an unplanned one. For many women, moving away from their birth plans because of unexpected medical complications always feels like an emergency. It’s important to remember that these unexpected changes to birth plans don’t have to have the negative associations attached to the word “emergency.”

  • “Cesarian Section.” uofmhealth. University of Michigan Health System. November 4 2015. Web.
  • “Having a C-section.” marchofdimes. March of Dimes. February 2015. Web.
  • Lara Salahi “5 Truths About (Unplanned) C-Sections.” boston. Boston.com. June 10 2013. Web.
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