Reasons for a cesarean section
A cesarean section is
a birth that occurs through an incision in the abdominal wall and uterus,
rather than through the vagina. Over the past 30 years, there has been a
gradual increase in the number of cesarean sections.
What are the reasons for a cesarean section?
There are many
reasons why a doctor may recommend a cesarean section. Some cesarean sections
are performed in emergencies, some are used to prevent emergencies, and some
are elective.
- Placenta previa: this occurs when the placenta lies low in the uterus
and partially or completely covers the cervix. One in 200 pregnant women
develops placenta previa in the third trimester. Treatment includes bed rest
and frequent monitoring. If total or partial placenta previa is diagnosed, a cesarean
section is usually necessary. If marginal placenta previa is diagnosed, vaginal
delivery is possible.
- Placental abruption: This is the separation of the placenta from the lining
of the uterus and usually occurs in the third trimester. Approximately 1% of
pregnant women experience placental abruption. The mother will experience
bleeding at the site of separation and pain in the uterus. This separation can
interfere with the baby's oxygen supply and, depending on the severity, an emergency
cesarean section may be performed.
- Uterine rupture: in about 1 in 1500 births, the uterus ruptures during
pregnancy or childbirth. This can cause the mother to bleed and interfere with
the baby's oxygen supply. This is a reason for an immediate cesarean section.
- Breech presentation: When the baby is in breech presentation, a cesarean
section is often the only option, although vaginal delivery may be performed in
some cases. However, if the baby is in distress or has a prolapsed cord (which
is more common in breech babies), a cesarean section is necessary. A cesarean
section may also be performed if the baby is premature.
- Prolapse of the umbilical cord: this situation does not happen often, but
when it does, an emergency cesarean section is performed. Cord prolapse occurs
when the cord slips through the cervix and protrudes from the vagina before the
baby is born. When the uterus contracts, it puts pressure on the umbilical
cord, which reduces blood flow to the baby.
- Fetal Distress: The most common cause of fetal distress is insufficient
oxygen being delivered to the baby. If fetal monitoring detects a problem with
the amount of oxygen your baby is receiving, an emergency cesarean section may
be performed.
- Failure to progress in labor: this can occur when the cervix is not
fully dilated, labor has slowed or stopped, or the baby is in a suboptimal
position for delivery. It can be correctly diagnosed when a woman is in the
second stage (more than 5 centimeters dilatation) because the first stage of
labor (0 to 4 centimeter dilatation) is almost always slow.
- Repeat cesarean section: 90% of women who have had a cesarean section are
candidates for a vaginal delivery after a cesarean section for their next
birth. The greatest risk associated with vaginal delivery after cesarean
section is uterine rupture, which occurs in 0.2–1.5% of vaginal births after cesarean
section. However, there are criteria you must meet in order to have a vaginal
birth after a cesarean section. Talk to your doctor about your current
situation and your options.
- Cephalotase disproportion: The true diagnosis of head-pelvic disproportion is when
the baby's head is too large or the mother's pelvis is too small for the baby
to pass.
- Active genital herpes: If the mother has an active outbreak of genital herpes
(diagnosed by a positive culture or an actual lesion), a cesarean section may
be scheduled to prevent the baby from being exposed to the virus as it passes
through the birth canal.
- Diabetes: If you develop gestational diabetes during pregnancy or if you have diabetes, you may have a large baby or other complications. This increases your chances of having a cesarean section.
- Preeclampsia: Preeclampsia is a condition associated with high blood pressure during pregnancy. This condition can prevent the placenta from getting the amount of blood it needs and reduce the oxygen supply to the baby. Sometimes childbirth is recommended as a treatment for this condition. Only in cases of severe preeclampsia is a cesarean section necessary.
- Birth defects: If a baby is diagnosed with a birth defect, a cesarean
section may be performed to reduce any further complications during delivery.
- Multiple births: twins can be born vaginally depending on their position, estimated weight and gestational age. Multiple three or more are less likely to be delivered vaginally.