Cesarean SectionWhat to Think About
If you plan to deliver vaginally
and have concerns about having an unnecessary
cesarean delivery, talk to your doctor or midwife
ahead of time. Ask in what types of situations cesarean section is usually used
and what measures he or she takes to promote a vaginal birth.
Public health experts have urged the North American obstetric community
to reduce the percentage of deliveries done by cesarean, identifying birth
scenarios that may not necessarily require surgical delivery. These
include:
- History of cesarean. Some women with a cesarean
scar can deliver vaginally, although there are risks involved in a
VBAC delivery. Some smaller hospitals no longer
provide VBAC, reflecting a trend toward greater medical caution with VBAC. If
you have had a previous cesarean, weigh the benefits and risks of vaginal
delivery with your doctor or midwife. For more information, see the topic
Vaginal Birth After Cesarean (VBAC).
- Fetal
distress. Deciding whether and when a fetus with a slowing heart rate should be
delivered by cesarean is a common judgment call during labor. Ultimately, a
health professional will lean toward caution and deliver by cesarean to prevent
harm to a newborn.
- Difficult, slow labor (dystocia). Dystocia can
often be corrected with
medication that restarts contractions (augmentation).
For women with a cesarean scar,
oxytocin must be used carefully to reduce the slight
risk of the scar rupturing during labor.
Some doctors are more likely to see a need for a cesarean
than others. For example, what one doctor considers a slow labor may be a
normal labor to another. However, all doctors are guided by the common goal of
a healthy labor and delivery for both the mother and her newborn.
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