A cesarean section is delivery of the fetus through incisions in the abdominal and uterine walls. In the United States the rate of cesarean sections is about 25 percent of all births.
No one goes into a pregnancy expecting a cesarean section — also called a c-section — but it could become necessary if there are complications during delivery. Read the answers to these commonly asked questions and you'll be prepared in the event that you need one.
Why are c-sections performed?
The following are the most common reasons a doctor has to perform a c-section:
- Failure to progress in labor and cephalopelvic disproportion (meaning the baby's head is too big to fit through the pelvic cavity): These factors account for about 30 percent of c-sections.
- Repeat c-sections: A patient who has already had a c-section may elect to have another one. This accounts for 30 percent of all c-sections. In fact, 60 to 80 percent of patients who have had nonemergency c-sections may safely undergo vaginal birth after cesarean (VBAC). You and your physician will make this decision based on the reason for your previous c-section.
- Breech presentation: When the baby is breech, or positioned feet first, a c-section may be necessary. Cesareans due to breech presentation are especially prevalent in preterm fetuses.
- Fetal distress: A c-section is required to hasten a safe delivery if the baby's health is jeopardized from decreased oxygen flow caused by factors such as maternal illness, cord compression, prolonged labor, or infection.
- Placenta previa or premature separation of the placenta: A c-section is clearly the safest way to protect mother and baby when these conditions are present.
How are c-sections performed?
Once it's determined that a c-section is absolutely necessary, you'll be given anesthesia, which is typically an epidural or a spinal block through a needle in your lower spine. In an emergency delivery, general anesthesia is given because it's faster to administer.
When you and the medical staff are certain that you're numb, a horizontal cut is made through your lower abdomen, followed by an incision in the lower uterine segment to ease out the baby (you may feel pulling). The time from the uterine incision to delivery should be less than three minutes. Since your baby does not have the advantage of being in the birth canal, which aids in squeezing the excess fluid lodged in the respiratory tract, suctioning the baby's nose and mouth to clear secretions is necessary. After that you should be able to hear that first wonderful cry!
At this time, the doctor will stitch you back up, while your baby is being given his first physical. After this, with assistance, you'll be able to hold and nurse your newborn.