What to Expect in a C-Section

Indications for a C-section

Let's start by defining a C-section. A vaginal delivery occurs when the baby is delivered through the vagina by natural means. In a C-section the baby does not go through the birth canal, but rather is pulled out through an incision made in the mother's abdomen and uterus. Unlike a vaginal delivery, a C-section involves a surgical procedure and is performed in an operating room under sterile conditions.

In the United States, approximately one in four babies is delivered by C-section, according to the American College of Obstetricians and Gynecologists.

When to Perform a C-Section

It's important to note that, in most cases, doctors will opt for a vaginal delivery over a C-section. The reason is that a vaginal delivery is almost always considered to be safer for the mother and baby unless extreme health conditions warrant otherwise. C-sections may be scheduled in advance if certain conditions are present and both the mother and doctor agree that it is necessary.

Often, however, C-sections are performed in emergency circumstances because conditions indicate that the mother or baby is at risk for a potential problem. If the mother's or baby's health is at risk, then a c-section might become the immediate alternative for saving lives. So, you may go into the delivery room anticipating a "normal" delivery and suddenly find that you're going to have a C-section. It's impossible to tell when this will occur, but some of the circumstances that might precipitate this decision on the part of your doctor are listed below.

Maternal Indications for a C-Section

There are several conditions in the mother that would necessitate a C-section (or in doctor jargon, absolute indications – in other words, the doctor would always suggest or resort to a C-section in these cases). If these conditions are noted in advance, chances are good that you'll be scheduled for a C-section when your baby is at term. These health conditions include the following:

• A woman who cannot labor for various reasons (for example, she has a serious heart condition).
• A woman who has a small or contracted pelvis that wouldn't allow the baby to push through (sometimes this is known in advance, but not always).
• Serious maternal health problems where a delivery through the vaginal area would put the baby at risk (for example, the mother has herpes or AIDs).
• If the mother has had a prior classical C-section in a previous birth.

Fetal Indications for a C-Section

In addition, there are conditions related to the baby's health that would prompt the doctor to suggest a C-section over a vaginal delivery. These conditions may not be known in advance of the baby's birth. They include the following:

• Problems with the umbilical cord; for example, the cord falls into the vagina (prolapsed cord, which would lead to emergency surgery) or the cord is pinched or compressed.
• Presence of a complete placenta previa (where the placenta is covering the cervix).
• Fetal distress – that is, the baby shows signs of distress such as a slowing heart rate or lactic acid buildup in the baby's bloodstream from lack of oxygen.
• Fetal illness, which might include babies diagnosed prenatally with certain medical conditions, such as a heart condition or spina bifida (a hole in the spinal cord).
• Multiple babies – that is, twins, triplets, or more.