Cesarean Section
About Cesareans
A cesarean section is surgery in which an incision is made through the abdomen and uterus to deliver the baby . Cesareans can save lives in the event of complications . However , they also carry risks . The cesarean rate in the United States has risen in recent decades to over 30 percent , meaning that more than one in every three babies is born via cesarean . An ideal rate of 10 – 15 percent has been established by the World Health Organization to achieve the safest outcomes . Rates vary widely between hospitals , with some studies showing a range of 7 – 70 percent . This extreme range among hospitals , as well as high rates nationally , indicate that many cesareans are being performed unnecessarily .
A cesarean section is major abdominal surgery that increases risk for both you and your baby compared to vaginal birth . Having a cesarean also increases risk in future pregnancies . For these reasons , cesareans should be done only when there is true medical necessity . In recent years , the American College of OB / GYNs ( ACOG ) has established new guidelines to help lower cesarean rates . ( See page 32 to review these guidelines .)
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Reasons for Cesareans
A cesarean may be done for a variety of reasons . It may be planned in advance , become necessary during labor with time to discuss your situation and options , or more rarely , a cesarean may need to be done rapidly in the event of an emergency . These are some of the reasons for cesareans .
Unplanned
• Prolonged first or second stage . This is highly subjective . Limits on time vary widely among health care providers . Also called “ failure to progress ” or labor arrest .
• Fetal distress : Baby shows ongoing signals via monitoring that labor is causing stress .
• CPD ( cephalopelvic disproportion ): Baby ’ s head won ’ t fit through the pelvis .
• Sudden medical complications , such as placental abruption ( placenta separates from the uterine wall ), umbilical cord prolapse ( cord is being compressed beneath baby ’ s head ) or other emergencies .
In addition to these , fetal malpresentation ( see previous page ) may require a planned or unplanned cesarean , if the position prevents vaginal birth and cannot be corrected .
Planned
• Placenta previa : Placenta covers the cervix , partially or completely .
• Sexually transmitted disease , such as HIV or an active herpes outbreak .
• Multiple gestation : Twins , triplets or more .
• Known medical complications .
29 Labor and Birth