Health care professionals have a variety of reasons for suggesting a cesarean birth. Some cesarean deliveries are performed in urgent situations, while others are done to prevent complications, and some are planned in advance.
What Causes Cesarean Deliveries?
A cesarean delivery involves making an incision in the abdominal wall and uterus instead of a vaginal birth. Here are some common reasons for cesarean deliveries:
- Placenta Previa: This condition occurs when the placenta is positioned low in the uterus, partially or completely covering the cervix. About 1 in every 200 pregnant women will face placenta previa during the third trimester. Depending on the severity, a cesarean is often required, especially if the placenta completely blocks the cervix.
- Placental Abruption: This happens when the placenta detaches from the uterine wall, usually in the third trimester. Approximately 1% of pregnant women will experience this. If it interferes with the baby’s oxygen supply or causes significant bleeding, an emergency cesarean may be necessary.
- Uterine Rupture: Occurring in about 1 in 1,500 births, a ruptured uterus can lead to severe bleeding and jeopardize the baby’s oxygen supply, necessitating an immediate cesarean.
- Breech Position: If a baby is in the breech position (feet or buttocks first), a cesarean is often the safest option, especially if there are signs of distress or cord prolapse, which is more common in breech births.
- Cord Prolapse: This rare situation arises when the umbilical cord slips through the cervix before the baby. It can cause pressure on the cord during contractions, reducing blood flow to the baby, often requiring emergency surgery.
- Fetal Distress: If monitoring reveals that the baby is not receiving sufficient oxygen, an emergency cesarean may be performed to ensure the baby’s safety.
- Failure to Progress in Labor: This can happen when the cervix does not dilate adequately, labor slows down, or the baby is not positioned correctly for delivery. This is typically assessed after reaching the second phase of labor.
- Repeat Cesarean: Around 90% of women who previously had a cesarean are suitable candidates for a vaginal birth after cesarean (VBAC). However, this comes with risks, including potential uterine rupture.
- Cephalopelvic Disproportion (CPD): This diagnosis indicates that a baby’s head is too large or the mother’s pelvis is too small for vaginal delivery.
- Active Genital Herpes: If the mother has an outbreak of genital herpes during labor, a cesarean may be scheduled to prevent the baby from exposure to the virus.
- Diabetes: Conditions like gestational diabetes can lead to larger babies or other complications, increasing the likelihood of needing a cesarean.
- Preeclampsia: This pregnancy complication is characterized by high blood pressure and can affect the placenta’s blood supply, sometimes requiring delivery via cesarean.
- Birth Defects: If a birth defect is diagnosed, a cesarean may help minimize complications during delivery.
- Multiple Births: While twins can sometimes be delivered vaginally, the chances decrease with three or more babies.
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In summary, cesarean births may be necessary for various medical and situational reasons, and understanding these can help expectant parents prepare for different birth scenarios.