Caesarean delivery: When is it the best option?

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C-section: When is it the best option?

Sometimes a C-section is safer for mother or baby than is a vaginal delivery.

Caesarean birth — also known as a C-section — is the birth of a baby through an incision in the mother's abdomen. Although C-sections are sometimes planned due to pregnancy complications or previous C-sections, most first-time C-sections occur unexpectedly.

Why a C-section might be needed

Sometimes a C-section is safer for mother or baby than is a vaginal delivery. Your health care provider may recommend a C-section if:

  • Your labor isn't progressing. Stalled labor is the most common reason for a C-section. Perhaps your cervix isn't opening enough despite strong contractions. Or your baby's head may simply be too big to pass through the birth canal.
  • Your baby's heartbeat suggests reduced oxygen supply. If your baby isn't getting enough oxygen or your health care provider is concerned about changes in your baby's heartbeat, he or she may recommend a C-section.
  • Your baby is in an abnormal position. Babies whose feet or buttocks enter the birth canal before the head are in the breech position. If your health care provider isn't able to move the baby into a more favorable position before labor begins, you may need a C-section to reduce the risk of complications. A C-section is also needed if your baby is lying horizontally across your uterus.
  • Your baby's head is in the wrong position. If your baby enters the birth canal chin up or with the top of the forehead or face leading the way, he or she may not fit through your pelvis. A C-section may be the safest way to deliver the baby.
  • You're carrying twins, triplets or other multiples. When you're carrying multiple babies, it's common for one or more of the babies to be in an abnormal position. In this case, Caesarean birth is often safer than vaginal birth — especially for the second baby.
  • There's a problem with your placenta. If the placenta detaches from your uterus before labor begins (placental abruption) or the placenta covers the opening of your cervix (placenta previa), C-section is often the safest option.
  • There's a problem with the umbilical cord. A C-section may be recommended if a loop of umbilical cord slips through your cervix ahead of your baby or if the cord is compressed by the uterus during contractions.
  • Your baby is very large. Some babies are simply too big to safely deliver vaginally.
  • You have a health problem. If you have a condition such as diabetes, heart disease, lung disease or high blood pressure, your health care provider may induce labor early to reduce the risk of pregnancy-related complications. If the induction isn't successful, you may need a C-section.

    In other cases, a C-section may be recommended if you have an active genital herpes infection or another condition your baby might acquire while passing through your birth canal.

  • Your baby has a health problem. A C-section may be safer for babies with certain developmental problems, such as failure of the spine to close properly (spina bifida) or excess fluid in the brain (hydrocephalus).
  • You've had a previous C-section. Depending on the type of incision and various other factors, you may be able to attempt a vaginal delivery after a previous C-section. In some cases, however, your health care provider may recommend a repeat C-section.

Why a C-section might be needed

Sometimes a C-section is safer for mother or baby than is a vaginal delivery. Your health care provider may recommend a C-section if:

  • Your labor isn't progressing. Stalled labor is the most common reason for a C-section. Perhaps your cervix isn't opening enough despite strong contractions. Or your baby's head may simply be too big to pass through the birth canal.
  • Your baby's heartbeat suggests reduced oxygen supply. If your baby isn't getting enough oxygen or your health care provider is concerned about changes in your baby's heartbeat, he or she may recommend a C-section.
  • Your baby is in an abnormal position. Babies whose feet or buttocks enter the birth canal before the head are in the breech position. If your health care provider isn't able to move the baby into a more favorable position before labor begins, you may need a C-section to reduce the risk of complications. A C-section is also needed if your baby is lying horizontally across your uterus.
  • Your baby's head is in the wrong position. If your baby enters the birth canal chin up or with the top of the forehead or face leading the way, he or she may not fit through your pelvis. A C-section may be the safest way to deliver the baby.
  • You're carrying twins, triplets or other multiples. When you're carrying multiple babies, it's common for one or more of the babies to be in an abnormal position. In this case, Caesarean birth is often safer than vaginal birth — especially for the second baby.
  • There's a problem with your placenta. If the placenta detaches from your uterus before labor begins (placental abruption) or the placenta covers the opening of your cervix (placenta previa), C-section is often the safest option.
  • There's a problem with the umbilical cord. A C-section may be recommended if a loop of umbilical cord slips through your cervix ahead of your baby or if the cord is compressed by the uterus during contractions.
  • Your baby is very large. Some babies are simply too big to safely deliver vaginally.
  • You have a health problem. If you have a condition such as diabetes, heart disease, lung disease or high blood pressure, your health care provider may induce labor early to reduce the risk of pregnancy-related complications. If the induction isn't successful, you may need a C-section.

    In other cases, a C-section may be recommended if you have an active genital herpes infection or another condition your baby might acquire while passing through your birth canal.

  • Your baby has a health problem. A C-section may be safer for babies with certain developmental problems, such as failure of the spine to close properly (spina bifida) or excess fluid in the brain (hydrocephalus).
  • You've had a previous C-section. Depending on the type of incision and various other factors, you may be able to attempt a vaginal delivery after a previous C-section. In some cases, however, your health care provider may recommend a repeat C-section.

Manage anxiety about C-sections

Getting the unexpected news that you need a C-section can be stressful, both for you and your partner. In an instant, your expectations about giving birth abruptly change. In case of emergency, your health care provider may not have time to explain the procedure and answer your questions.

Discuss the possibility of a C-section with your health care provider well before your due date. Ask questions, share your concerns and review the circumstances that might make a C-section the best option. Remind yourself that your health and your baby's health are more important than is the method of delivery. Look forward to a complete recovery and a joyful start with your new baby.

Last Updated: 03/02/2007
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