Cesarean Delivery
“I really don’t want to have a C section.”
actual quote from a patient at her first prenatal visit
Very few people ever really want to have a Cesarean section. On the other hand, when you genuinely need one, you really want one.
The name Cesarean Section:
The name of the procedure either historically or mythically refers to the birth of Julius Caesar who was taken directly from the abdomen of his mother. The cesarean section is a major but generally straightforward and common operation. Approximately 1/3 of all the babies born in this country are born by cesarean section.
Indications, or reason for doing C sections :
The reasons for doing C-sections are many. We will restrict our attention to legitimate and evidence-based indications. There has been concern worldwide over unduly increasing rates of cesarean sections. The reasons for this are also many, ranging from inappropriate indications, fear of being sued, to the inability of some facilities to handle higher risk vaginal birth after cesarean section (VBAC). The obesity epidemic is probably also playing a role, since these patients are more likely to have larger babies and are at higher risk for the need for cesarean sections.
Evidence based indications for cesarean sections fall into just a few categories:
- Baby does not tolerate labor well enough
- Contractions are adequate and yet labor does not progress
- Mother's health is jeopardized by the labor process. Examples would include excessive bleeding, placenta previa, where the placenta blocks the cervical opening, uncontrolled high blood pressure, or other less common problems.
- Baby is not head down, i.e. baby is breech or transverse.
See the Venus de Milo for an idea of
what a healed incision will probably look like.
