Most babies are born by vaginal delivery. However, there are times, ether due to health risks to the mother or the baby, a cesarean delivery is necessary. Cesarean birth is the birth of a baby through surgical incisions (cuts) made in the abdomen and then the uterus. Some cesareans are planned ahead of time; others are performed as a result of conditions that come up during labor that were unknown before hand. It is a good idea as part of your planning for labor and birth that you lean about cesarean birth so you will know what to expect in the event you have to have one.

There are many reasons for having a c-section, some of these include:

• Failure of Labor to Progress

About one third of all cesarean births are performed because the mother’s labor does not progress as it should. For example, the uterine contractions may not open the cervix enough for the baby to move into the birth canal and out of the vagina. If labor is moving slowly, the doctor can speed up labor with medicine. Labor can also be slowed down because of medicine used to ease labor pains. The doctor may try reducing the pain medicine to see if this will speed up labor. Sometimes it can take many hours to find out that labor is not progressing well. Since it takes time to watch the progress of labor, your doctor may follow the progress of your labor for several hours before deciding on a cesarean section.

• More than one baby (multiple pregnancy)

If you are having more than one baby, you may need a cesarean delivery. It is common to have a vaginal birth for twins. However, if the babies are being born too soon or they are not in good positions inside the uterus, a cesarean birth may be needed. Also, the more babies you are having the higher your chances of having a cesarean birth.

• Health Risks for Baby

Keep in mind there are two of you going through labor. Your baby will also be monitored through the labor process. If you baby starts having trouble during labor he may need to be delivered by cesarean. Reasons for trouble include the umbilical cord gets pinched or compressed so that not enough blood—which carries oxygen—is getting through to you baby. Also, fetal monitoring may detect an abnormal heart rate for your baby making it necessary for cesarean birth.

• Having Had a Cesarean Birth Previously

If you had a cesarean birth previously, that will play a large part in whether you can try having a vaginal birth in a later pregnancy. Many women who have had a cesarean birth are able to give birth vaginally later. However, if there is a chance that your previous cesarean birth puts you at risk for a rupture of your uterus, you do not want to try a vaginal birth after cesarean.

So how do you know if you are at risk for a ruptured uterus? The type of incision made in your uterus—not the skin incision on your abdomen—for your previous cesarean makes a big difference. If you had a classical incision—a high vertical incision—you are at increased risk for rupturing the uterus during the pressures of labor. The rupture can occur at the site of the old cesarean incision because of the weakening of the uterine wall. If you had a classical incision, you should not try a vaginal birth on subsequent pregnancies.

Additional Cesarean Causes

• Your baby may not be in the “head first” position—he may be feet first or sometimes even an arm or leg can present first

• Your baby may be too large to pass through the vagina which can happen if you have gestational diabetes and have a large baby

• There are certain infections a mother can have that make it better for the baby to be born by cesarean, including herpes and HIV.

As you see, there are many reasons for a cesarean birth. Ask your doctor or the hospital where you plan to deliver if they have classes for mothers who may need a cesarean.

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