C-Section: Why You Could Need One

Why would I require a c-section?

There are numerous reasons for a cesarean birth. Some are primarily for the woman's safety, others to benefit the fetus, still others benefit both mother and child.

Some of the most common indications for a C-section are:

  • Great difficulty with the fetus to passing through the birth canal. The medical term is dystocia (Dis-TOE-sha). This is most frequently caused by the fetus' head being too large for the woman's pelvis.
  • Abnormal presentation of the fetus. Normally the fetus comes down through the birth canal head tucked to chest, with the crown first. In this position, the baby is compressed as much as it can be with the largest part clearing first. Other positions risk being too large, in some cross-sections, to pass, or passing smaller parts of the body first leaving the head trapped in the woman. This is closely related to the first concept of dystocia.
  • Failure of natural labor to begin and/or to respond to induction in a past due pregnancy.
  • Fetal abnormalities. Labor and birth is a big stress to the infant, as well as the mother. Fetuses with known, more serious birth defects may not do well with this otherwise normal stress.
  • Abnormal amounts of bleeding. So that the source of bleeding can be identified and stopped quickly.
  • The umbilical cord falls into the vagina.
  • Problems with the placenta such as the placenta separating before the birth or covering the cervix.
  • Fetal distress, usually as determined by fetal monitoring during labor, is a very common cause.
  • Maternal condition such as diabetes, active herpes lesions, uterine abnormalities or hypertension.
  • Previous cesarean has long been used as a reason for doing a cesarean, as there were concerns about the uterus rupturing at the point of the previous scar, during labor. With the low transverse scars that have been standard for many years, the stress on the scar tissue is much less and this reason has lost favor.
  • Multiple births. Even with a set of twins a c-section is standard in most cases.

In many cases a woman will know whether she will have to have a cesarean or not. Her doctor will already have discovered that for instance the fetus is positioned abnormally or she is pregnant with triplets. In other cases the need for cesarean will arise during labor.

It is important to note though that all problems describe above do not always necessitate a C-section. There are many women that vaginally deliver despite a problematic birth. Vaginal birth is always preferred, all other things being equal. The recovery time is a lot shorter, in the long run there is less pain for the woman, and the medical risks for the mother a lot lower.

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