Having a cesarean birth, or cesarean section, means your baby is delivered through incisions in the abdominal wall and uterus instead of being delivered vaginally. Some cesarean sections are planned because it is known prior to labor that a vaginal delivery is not recommended for the safety of the mother and/or baby. Many however are not planned and occur because of events in labor that indicate a vaginal delivery is not possible or may jeopardize the safety of the mother and/or baby. Because many cesarean births are not planned, it is important to discuss this with your healthcare provider or childbirth educator to become familiar with the procedures involved in a cesarean birth at your hospital. Even though a cesarean section is major abdominal surgery, advance preparation can make it a satisfying birth experience for the entire family.
Indications for Cesarean Birth
Although there are several reasons that a cesarean birth is indicated, the ones listed below are the most common:
- Cephalopelvic Disproportion (CPD)
Occurs when the baby's head will not fit through the pelvis. This diagnosis may also be used to indicate a labor that fails to progress, (a prolonged labor, an extended period of time since rupture of membranes or weak, ineffective contractions.)
- Fetal Distress
The baby is not receiving enough oxygen. It may be indicated by an abnormal fetal tracing, or a drop in the fetal heart rate when your healthcare provider or labor nurse listens to the rate during or after a contraction.
- Abnormal Position of the Baby
Instead of the baby's head presenting first in the pelvis with his/her chin tucked inward, the presenting part of the baby may be his/her head extended outward, the shoulder, bottom (breech) or leg(s).
- Prolapsed Cord
When the umbilical cord is in the vagina ahead of the baby. This most commonly occurs after the membranes rupture and the baby is in a breech position or his/her head is not well engaged in the pelvis. This is an emergency and an immediate cesarean section is necessary to prevent the presenting part from compressing the cord and cutting off the oxygen supply to the baby.
- Abruptio Placentae
The placenta partially or completely separates from the uterine wall before the baby is born. This is an emergency and an immediate cesarean section is necessary to prevent the mother from hemorrhaging, which can cause the baby to lose all or part of his/her oxygen supply.
- Placenta Previa
A condition in which the placenta partially or completely covers the cervix. The degree of severity determines whether or not a cesarean section is indicated. If the cervix is completely covered, a cesarean is mandatory since the placenta would deliver first in a vaginal delivery and the baby would lose his/her oxygen supply.