Do you Know Reasons for a Cesarean birth

Cesarean section is on the rise in the U.S. About 3 women in 10 now give birth by c-section, a major abdominal surgery. Considerable controversy exists about risks and benefits of cesarean section as compared with vaginal birth. There is confusion and disagreement about the safety of vaginal birth, the safety of cesarean section, and the role that cesarean section might play in preventing "pelvic floor" dysfunction such as female incontinence in later life.

 

 

Some women walk into their pregnancy already pegged for the procedure. For example, in expectant mothers with chronic conditions like heart disease, diabetes, high blood pressure, and kidney disease, vaginal delivery can be dangerously stressful to the body, making a cesarean a safer option. Scheduled C-sections are also a necessity in HIV-positive women and those with an active genital herpes infection, because HIV and the herpes virus can be transmitted to the baby during delivery. Here are more reasons.

 

Reasons for a Scheduled C-Section:

• If you are expecting your first baby: As a first-time expectant mother, you have the greatest opportunity to determine the kind of birth you will have, and many options are open to you. In a very real sense, when you make plans for this first baby, you are making plans for all your babies. For example, if you have a cesarean for this birth, you probably will have a cesarean for any and all future babies because it is becoming increasingly difficult to find caregivers and hospitals that support VBAC ("vee-back," vaginal birth after cesarean). If you have a cesarean now, you may thus have fewer options in any future pregnancies, and you and your babies may face extra risks of repeated cesareans. If your first birth is not a c-section, your likelihood of having vaginal births in the future is high.
• If you plan a large family: The likelihood of certain life-threatening complications that may affect both you and any future babies goes up as the number of c-sections goes up.
• If you are an older pregnant woman: Women having first babies in their 30s are much more likely to have them by c-section than younger women. Many of these excess c-sections are due to non-medical factors, such as the false belief that planned c-section is always safer for babies.
• If you have had previous abdominal or pelvic surgery: Every operation increases the amount of internal scar tissue (adhesions) and therefore the problems adhesions can cause. These problems include chronic pain and a twisted and blocked bowel. In addition, when there are adhesions further surgery is more difficult and more likely to result in injuries to organs or blood vessels.
• An illness or a congenital condition in the baby that might make the already tricky journey through the birth canal even more treacherous
• When the baby is too large to move safely (if at all) through the birth canal (an increasingly prevalent problem, because women are packing on more pounds than they should during pregnancy)
• When the baby is in a breech position and can't be turned
• You are having triplets or more
• Placenta problems — if the placenta is partly or completely blocking the cervical opening (placenta previa) or has separated from the uterine wall (abruptio placenta).
• If you develop preeclampsia (pregnancy-induced high blood pressure) or eclampsia (a very rare progression of preeclampsia that affects the central nervous system, causing seizures) and treatment isn't working, your practitioner might opt for a cesarean to protect both of you.
• If you've had a previous C-section (although vaginal birth after delivery, or VBAC, is frequently successful and now more available thanks to new guidelines; see ACOG Issues News VBAC Guidelines)

Reasons for an Unscheduled C-Section

Far more frequently, the need for a cesarean isn't obvious until a woman is well into labor. If your labor just can't seem to get moving in the first place (your cervix isn't dilating although you're having contractions) after 24 or 25 hours in a first-time mother, or less if it is not your first delivery, your doctor might decide on surgery.

 

Another possibility: You might sail right through the early stage of labor (dilation to three centimeters), only to have progress grind to a halt. While it's possible that oxytocin or another labor stimulator could jump-start the contractions, if the problem is that the baby's head is too big to fit through the pelvis (which is the case about half the time) a cesarean will be necessary — as it will be if you are becoming too exhausted, if the fetal monitor is picking up signs of fetal distress, if the umbilical cord slips into the birth canal in advance of the baby (it will be compressed as the baby comes through, cutting off his or her oxygen supply), or if your uterus ruptures.