The safety risks to mother and baby can be greater with a cesarean than a vaginal delivery, which has led medical organizations such as the Society of Maternal Fetal Medicine (SMFM) and the American College of Obstetricians and Gynecologists (ACOG) to create guidance for safely reducing the number of first cesareans. Why would you need a scheduled cesarean section? What are the most common reasons for this to be decided even before labor begins?
Reasons for Cesarean Scheduling Before Labor
There are medical reasons that your doctor may plan a c-section before or at the beginning of labor. Most of these reasons have to do with the safety of the mother and/or the baby. They include, but are not limited to:
Placenta previa: In this condition, the placenta is near or covering the cervix. This orientation of the placenta can block the pathway for a vaginal birth or may present a bleeding risk during labor. Certain fetal positions: Your baby’s position in the uterus may mean that a vaginal birth is not safe for them; in some cases vaginal birth may be impossible. These positions include a transverse lie and some breech positions. Your doctor or midwife may discuss ways to encourage baby into a better position, but this is not always possible or successful. Higher-order multiples: With every baby in the uterus the risk of a cesarean birth increases. While some twins and triplets are born vaginally, the more babies, the less likely a vaginal birth will be possible. Many times this is due to the babies’ positions in the uterus. Active maternal herpes: If you have herpes and you have an active lesion on your genitals, you may be encouraged to have a cesarean to prevent transmission of the virus to your baby.
Other Reasons
These reasons are certainly not the only reasons to have a cesarean birth scheduled prior to labor. There are a multitude of reasons why a cesarean may be the best choice for you. Here are a few other reasons why a c-section may be the safest route of birth for you:
Previous invasive uterine surgery, including a previous cesarean incisionCertain fetal conditionsDiseases that may make vaginal birth difficult, like a pulmonary or coronary disease of the motherHIV-positive with a high viral load at the time of birth
When a scheduled cesarean is discussed, be sure to ask questions about the procedure, including the reasons for doing it, what the benefits are, what the risks are and what alternatives exist for you and your family. You should also be sure to talk to your practitioner and explain how you feel about this decision. If this is something that you had really hoped to avoid, it can take time to emotionally adjust to the news. This doesn’t mean that you are selfish or wrong, it’s simply an adjustment period after a hard decision.
