Cesarean Section

Some cesarean deliveries are planned ahead of time. Others are done when a quick delivery is needed to ensure the mother's and infant's well-being.

Planned cesarean

Some cesarean sections are planned when a known medical problem would make labor dangerous for the mother or baby. Medical reasons for a planned cesarean may include:

• A fetus in any position that is not head-down (including Reference breech position Opens New Window). For more information, see the topic Reference Breech Position and Breech Birth.
• Decreased blood supply to the Reference placenta Opens New Window before birth, which may lead to a small baby.
• Estimated fetal size of over 9 lb (4.1 kg) to 10 lb (4.5 kg) or more.
• A maternal disease or condition that may be made worse by the stress of labor. One example is heart disease.
• A known health problem with the baby, such as Reference spina bifida Opens New Window.
• A placenta that is blocking the Reference cervix Opens New Window (Reference placenta previa Opens New Window). For more information, see the topic Reference Placenta Previa.
• Open sores from active Reference genital herpes Opens New Window near the due date, which can be passed to the fetus during vaginal delivery.
• Infection with Reference human immunodeficiency virus (HIV) Opens New Window, which can be passed to the fetus during vaginal delivery.^{Reference 2}
• Multiple pregnancy. The direction and size of the incision depends on the position of the fetuses. In particular, cesarean delivery may be needed for multiple births involving:
  • Twins that share one amniotic sac (monoamniotic twins), because of the risk that the cords will get tangled.
  • Three fetuses or more.
  • Twins that are joined by any part of the body (conjoined).
  • An overstretched uterus that cannot contract adequately during labor (uterine inertia), making labor prolonged and difficult.
  • Poorly positioned or large fetuses.

Many cesarean deliveries are planned ahead of time for women who have had a cesarean in the past. Medical reasons for a planned repeat cesarean may include:

• A current problem that has led to difficult labor and cesarean before, such as a narrow pelvis and a large fetus (cephalopelvic disproportion).
• Factors that increase the Reference risk of uterine rupture during labor, such as having a vertical scar, triplets or more, or a very large fetus thought to weigh 9 lb (4.1 kg) to 10 lb (4.5 kg) or more. For more information, see the topic Reference Vaginal Birth After Cesarean (VBAC).
• No access to constant medical supervision by a cesarean-trained doctor during active labor, or no available facilities for an emergency cesarean.

Opens New Window Pregnancy: Should I Try Vaginal Birth After a Past C-Section (VBAC)? Opens New Window

Some women request to have a C-section even though there is no medical need for it. Experts don't agree on whether C-sections should be done when there is no medical reason. Most mothers and babies do well after C-section. But it's major surgery, and major surgery has some risks.

Emergency cesarean

Some cesarean sections are done without planning, after labor has started. Medical reasons for an emergency cesarean may include:

• Fetal distress (suggested by a very rapid or very slow heart rate).
• Reference Placenta abruptio Opens New Window, which can cause excessive bleeding (hemorrhage) and decreased oxygen supply to the fetus. For more information, see the topic Reference Placenta Abruptio.
• Reference Umbilical cord Opens New Window problems that decrease or cut off fetal blood supply, as when the cord has slipped into the birth canal ahead of the fetus, and the fetus moves into the birth canal and presses against the cord (cord prolapse).

Other reasons you might need a cesarean

• Difficult, slow labor (dystocia)
• Labor that has stopped completely (failure to progress)
• Cephalopelvic disproportion, a combination of the fetus having a large head and the mother having a narrow pelvic structure. This condition is often linked to failure to progress or dystocia.

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This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Reference Terms of Use. Reference How this information was developed to help you make better health decisions.