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When a C-Section is Recommended

In the US, 32% of women gave birth by C-section in 2013 versus only 20% in 1996. While c-sections have continued to improve infant mortality rate by quickly delivering a baby in a complicated situation, vaginal birth is still nature’s best way of bringing a baby into the world. It’s important to note that this increase also reflects a rise in the number of unnecessary c-sections performed, which can pose risks to both mother and baby.

If you are pregnant and have questions about c-sections, it’s important to discuss your concerns and health history with your doctor so that you can make an informed decision together.

Risks of Cesarean Sections

While some women think it convenient to schedule their delivery instead of waiting for labor to begin naturally, a c-section that is not medically necessary carries several risks. Why is the procedure not recommended?

  • As it is major surgery, the process will require a longer hospital stay, painful incision, and a higher risk of hospital readmission for blood clots, reactions to anesthesia, and wound infection.
  • Having one c-section may require having future children born that way.
  • Babies delivered by c-section earlier than 39 weeks often require time in the NICU, as the babies do not have the opportunity to push fluid from the lungs during the surgery as they would in a vaginal delivery.
  • Either the mother or the fetus could suffer surgical injuries.

While elective C-sections are available for many reasons, vaginal deliveries are still strongly recommended, when possible.

Planning Ahead For Cesarean Surgery

There are some situations where you and your doctor will make a decision to deliver via c-section before you go into labor. Planned c-sections are sometimes recommended in the following circumstances:

  • Multiple pregnancy, especially when multiple fetuses share an amniotic sack, are conjoined, or are larger or poorly positioned.
  • Certain maternal medical conditions, such as heart disease, high blood pressure, HIV, or active genital herpes that could make delivery dangerous for the mother or the fetus.
  • Known health conditions in the fetus.
  • Mechanical obstructions, such as a displaced pelvic fracture, a large fibroid position in the birth canal, or a baby with extreme hydrocephalus.
  • Poor positioning of the fetus, such as breech, where the head is not facing down.
  • Fetal size of over 9 to 10lbs.
  • Placenta blocking the cervix (placenta previa).
  • Decreased blood supply to the placenta during pregnancy.
  • A recurrence of a condition that required a c-section before, such as a large fetus or a small pelvis, or lack of medical professionals trained in VBAC (Vaginal Birth After Cesarean).

Emergency C-Sections

Many women who anticipate having vaginal deliveries find themselves in need of a c-section after labor has started. Common reasons include:

  • Fetal distress, where the fetal heart monitor indicates a very slow heart rate.
  • Umbilical cord issues that threaten to cut off or decrease the fetal blood supply, where the cord slips into the birth canal before the fetus, or when it is at risk of being compressed by the fetus.
  • Placental abruption, which leads to hemorrhaging or decreased blood supply for the fetus.
  • Slow, difficult labor or labor that has stopped.
  • Fetus’s head is too large for the birth canal due to a small pelvic diameter of the mother (cephalopelvic disproportion).

If you are pregnant and have questions about cesarean delivery, confer with your doctor at Rocky Mountain Women’s Health Center about the risks and benefits of a c-section.

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