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Cesarean Delivery
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A Cesarean delivery is a birth through an incision in the abdominal wall and uterus instead of a birth through the vagina. There has been a gradual increase in cesarean births over the past 30 years. In June of 2003, the US Centers for Disease Control and Prevention (CDC) reported the national cesarean birth rate was the highest ever at 26.1%, which is over a quarter of all deliveries. This means that over 1 in 4 women will experience a cesarean delivery. The World Health Organization has stated that every region globally really should not have a cesarean rate higher than 10-15%.
There are many reasons why a health care provider may feel that you need to have a cesarean delivery. Some reasons occur in critical situations, some are used to prevent critical situations from occurring, and some are on a more elective basis.
The common reasons would be:
Placenta Previa: Occurs when the placenta lies low in the uterus covering the cervix partially or completely. Only one in every 200 pregnant women will experience placenta previa during their third trimester, which is considerate a very low percentage. The treatment would involve resting in bed and frequent trips to the hospital. A cesarean is usually necessary only if a complete or partial placenta previa has been diagnosed, if a marginal placenta previa has been diagnosed, than a vaginal delivery may be an option.
Placental Abruption: This means a separation of the placenta from the uterine lining that normally occurs in the third trimester. But approximately only 1% of all pregnant women will experience placental abruption. The mother would experience bleeding from the site of the separation and pain in the uterus. This separation can interfere with oxygen getting to the baby and, an emergency cesarean may be performed depending on the severity.
Uterine Rupture: Approximately one in every 1,500 births the uterus tears during pregnancy or labor. This can lead to hemorrhaging in the mother and interfere with the babies oxygen supply. That would be a cause for immediate cesarean.
Breech Position: This might be the only case when a cesarean delivery is often the only option, although a vaginal delivery can be done under certain circumstances. However, if the baby is in distress or has cord prolapse (which is common in breech babies) a cesarean will be done at no doubt. A cesarean may also be done if the baby is premature.
Cord Prolapse: This is one of the situations that do not occur very often, but when it does an emergency cesarean is done. A cord prolapse means when the umbilical cord slips through the cervix and protrudes from the vagina before the baby is born. When the uterus contracts it causes pressure on the umbilical cord which diminishes the blood flow to the baby.
Fetal Distress: The most common cause of fetal distress is lack of oxygen to the baby, then if fetal monitoring detects a problem with the amount of oxygen that your baby is receiving than an emergency cesarean is performed.
Failure to progress in labor: This is when the cervix does not dilate completely, and labor slows down or stops, or the baby is not in an optimal delivery position. This can be diagnosed correctly when women is more than 5,0 cm of dilation.
Repeat Cesarean: You may be surprised to find out that 90% of women who have under gone a previous cesarean are candidates for a vaginal birth after delivery (VBAC). The biggest risk involved in a VBAC is uterine rupture. However, there is a criteria you must meet in order to have a VBAC. Consult with your doctor about your current situation and your options.
Cephalopelvic Disproportion (CPD): A diagnosis of CPD occurs when a babies head is too large or a mother pelvis is too small to allow for the baby to pass through.
Active genital herpes: If the mother has an active outbreak of genital herpes (diagnosed by a positive culture or actual lesions) a cesarean may be scheduled to prevent the baby from being exposed to the virus while passing through the birth canal.
Diabetes: If you develop gestational diabetes during your pregnancy or are diabetic, you may have a large baby or other complications. This increases your chances of having a cesarean.
Preeclampsia: This is a condition of high blood pressure during pregnancy. This condition could prevent the placenta from getting the proper amount of blood needed and decreases oxygen flow to the baby. Delivery is sometimes recommended as a form of treatment for this condition. Only if preeclampsia is severe a cesarean is needed.
Birth defects: If a baby has been diagnosed with a birth defect, a cesarean may be done to help reduce any further complications during delivery.
Multiple births: Twins may be delivered vaginally depending on their positions, estimated weights and gestational age. Multiples of three or more are less likely to be allowed to deliver vaginally.
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