When Should You Consider a C-Section?

There are occasions when a pregnant woman puts herself and her child at risk by having a vaginal birth. When there is a likelihood of injury to the mother or her infant, doctors frequently perform the delivery by a Cesarean section, or C-section. With a C-section delivery, the doctor makes an incision through the abdominal wall and uterus and removes the baby through that incision instead of through the vagina.

Cesarean deliveries have increased gradually during the last 25 years. The Centers for Disease Control and Prevention (CDC) reported that as of November 2005, the rate of C-sections had reached a high of 29.1 percent, which is greater than one in four births. However, the World Health Organization says that a Cesarean rate that is greater than 10 to 15 percent is unnecessary.

Reasons for a Cesarean Delivery

Numerous reasons might cause a physician to recommend a C-section, including life-threatening situations, measures meant to prevent life-threatening complications and elective reasons. Here is a list of various factors that might require an emergency Cesarean delivery.

  • Uterine rupture – The uterus tears during labor or pregnancy in approximately one out of every 1,500 births. This causes the mother to hemorrhage, which blocks the baby’s air supply. Uterine rupture is cause for an immediate C-section.
  • Breech position – A C-section is frequently the only answer to a breech baby. In some cases, a vaginal delivery is possible, but if the baby is in danger or is experiencing cord prolapse, a Cesarean is required. Cord prolapse is more likely in breech babies. A premature baby might also require a Cesarean delivery.
  • Failure to progress in labor – This occurs when the cervix doesn’t dilate fully, the baby isn’t in the optimal position for vaginal delivery or labor has slowed or ceased. This is the correct option when the woman has passed into the second phase of her labor because the first phase is usually slow.
  • Preeclampsia – High blood pressure during pregnancy is called preeclampsia. It precludes the placenta from receiving adequate blood, which decreases oxygen flow to the fetus. A C-section is only needed in cases of extreme preeclampsia.
  • Cephalopelvic Disproportion (CPD) – This occurs when the mother’s pelvis is too small or the baby’s head is too large to permit a vaginal delivery.
  • Active genital herpes – If the mother has genital herpes, a Cesarean may be performed to halt the infant’s exposure to the virus during passage through the birth canal.
  • Repeat C-section – A vaginal birth after Cesarean (VBAC) is possible for 90 percent of women who had a C-section. The greatest risk during a VBAC is uterine rupture, which can occur up to 1.5 percent of the time. The physician can recommend a C-section or VBAC based on certain criteria.
  • Diabetes – Women who have diabetes or develop gestational diabetes during their pregnancy may have complications, such as a large baby, which increases the likelihood of a C-section.
  • Fetal distress – Lack of oxygen to the fetus is the most common cause of fetal distress. A C-section should be performed if fetal monitoring uncovers a problem with the baby’s oxygen supply.
  • Placental abruption – About one percent of pregnant women will suffer placental abruption, which is the separation of the placenta from the uterine lining. This situation interferes with the amount of oxygen the fetus receives and requires an emergency C-section in severe instances.
  • Placenta previa – One out of every 200 pregnant women will suffer this condition in their third trimester. It happens when the placenta is low in the uterus and partly or completely covers the cervix. Treatment usually includes bed rest and continuous monitoring. A C-section is necessary in cases of a complete or partial placenta previa. In cases of marginal placenta previa, a vaginal delivery may be possible.
  • Birth defects – A C-section may be performed if the baby has been diagnosed with a birth defect. This prevents other complications during the birth.
  • Multiple births – Twins can be delivered vaginally, but it depends on their gestational age, their position and estimated weights. Three or more babies are more likely to be delivered by Cesarean.

Failure to promptly perform a c-section can have severe consequences for the mother and/or baby. If you have concerns about your child’s delivery, contact the medical malpractice team of Roenbaum & Associates at 1-888-664-6974.