During pregnancy you will be having conversations with your caregiver about delivery options which may include elective c-section. I’ve had friends tell me they were asked outright if they wanted to set a date for cesarean delivery on their first meeting with their caregiver.

When any form of medical procedure  including medication, a test, or a form of treatment is offered to you, you are entitled to "informed consent". This is a legal right which means your caregiver has a responsibility to explain; reason this type of care is being offered; exactly what it will involve; all the risks and associated benefits of this type of care;  potential alternatives  and  their risks and benefits. You are also entitled to request a copy of your medical records  and to ask for a second opinion.

It is also your legal right to accept or not accept the care that is offered. Should you choose to not except this is called an ‘informed refusal’. It is a good idea to go over your options in this way with your caregiver during your pregnancy. Equally your caregiver has rights too, for example if you requested a c-section without any medical need for it your caregiver has the right to refuse to carry out your wish.

Most of us  are conditioned to see those in the medical profession as authority figures and to

simply accept what it is that they tell us. It is a good idea then to make a list of questions before you meet with them and to make notes of their responses. When you are with them it is important to feel okay to ask further questions, ask for clarification, and explanations,  to ask for  sources of information, and the sources for research that support their recommendation.

It’s also important that you don’t feel pressured into making a decision before you’re ready and it’s perfectly acceptable to have more time, and to even get a second opinion if you feel uncomfortable with what is being recommended. The bottom line is if you have questions ask them I keep asking until you get the answers you need.

Some questions to consider asking are your caregivers feelings and past history with a) epidurals b) inducing labor c) episiotomies (surgical cut to enlarge the vaginal opening) d) slow or stalled labor e)continuous electronic fetal monitoring CEFM f) labor support from partner, doula etc.

These are all issues to be familiar with yourself and to consider what you ideally would like to happen. We can’t control how the birth will go, but we can create the circumstances that will give us the best opportunity for what we want to be what happens.

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1. Reasons for a C-Section

There are essentially two varieties of C-section delivery, planned and emergency. Here I will write about reasons why either might take place.

First planned or as it is also know elective cesarean. There are many reasons for a planned or elective c-section, below are five of the most common.

• The baby is in a breech or transverse position, this is when the head is upwards, instead of downward near the cervix. When a baby is breech at around 38 weeks, and time for the baby has run out, the doctor will schedule the c-section, usually somewhere around 39-40 weeks. 


• Multiple babies. Twins can prove difficult to deliver vaginally and in such cases a c-section is chosen. Any more than twins from Triplets onwards will almost always be delivered by cesarean. 


• If you have delivered before by c-section (particularly a classical c-section) many doctors won’t allow you to deliver vaginally because the scar on the uterus from your earlier c-section may tear. This is called uterine rupture. 


• Placenta prevail. This is when the placenta is at the bottom of the womb and covers all or part of the cervix, making a vaginal delivery dangerous. 


• The mother or the baby has a health condition that may make the stress of the vaginal birth a risky option.

Emergency C-section happens when a woman has had no indication of needing surgical intervention for the delivery until a risk arises very late in the pregnancy or more often during labor (this is what happened to me). Here are common reasons why a woman might need an emergency C-section.

• The baby becomes distressed during labor. For example if the baby’s heart rate drops too low, or is too fast, an emergency C-section can be done to ensure the health of the baby. 
• If labor is either very hard or stops completely, many doctors will order an emergency C-section.

• If the mother has a genital herpes outbreak while in labor, a c-section is necessary because the infection can be deadly to the baby. 
• In the event of a prolapsed cord (the umbilical cord coming out of the cervix), a C-section is performed immediately because the supply of oxygen to the baby can be cut off.
* The baby is just too big to deliver vaginally.


• Other health concerns that may warrant an emergency C-section are low amniotic fluid, placental abruption (Placenta abruption is, separation of the placenta from the site of uterine implantation, before delivery of the baby.), and meconium (faeces from the baby) in the amniotic fluid.

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1. What Is a C-Section?
2. C-Section – Potential Risks
3. C Section – Questioning Your Caregiver

What is Cesarean Delivery?

A caesarean section, commonly shortened to C-section, is a birth delivery whereby doctors remove the baby from of the womb surgically. There is reason to believe that ceasarean delivery was practiced as long ago as ancient Egypt, Rome, Greece, Persia and even some parts of Europe. It was in those times used to deliver babies from mothers who died during childbirth, a much more common occurrence than today. The first recorded surgery where the mother survived occurred in 1500 in Switzerland and the first in America in 1794.

With the development of modern surgery, anesthesia and antibiotics, the C-section process is now very safe. There are now two types of C-section procedures: one performed by what is called a ‘classic’ incision and the other via what is called a Munro-Kerr incision after it’s inventor.

The classic C-section involves a longer, vertical incision down the lower abdomen. After this initial incision, doctors cut through the underlying layers of tissue to access the uterus. Here another vertical incision is made, and the baby is removed. The vertical incision gave obstetricians plenty of space to deliver the baby. It became clear that the larger incision increased the mother’s risk of infection. It also meant the uterus was more at risk from rupturing in later pregnancies.

The more recent Munro-Kerr incision is smaller, horizontal and made near the bikini line. After this initial incision

the doctor cuts through the layers of body tissues to access the uterus. A final incision is then made into the womb to let the amniotic fluid drain away. This this makes more room in the uterus, obstetricians can then deliver the baby.Bbecause of the Munro-Kerr incision is smaller it is possible that forceps or a vacuum may be needed to complete the delivery.

Unfortunately, forceps and vacuum-assisted delivery can sometimes cause injuries to the baby. These can include bruising, lacerations, fractures, and in extremes, brain hemorrhaging.

To prepare for the delivery, you’ll probably have various monitors in place to keep an eye on your heart rate, breathing, and blood pressure. Your mouth and nose covered with an oxygen mask or a tube placed in your nostrils to give you oxygen. A catheter (a thin tube) will be inserted into your bladder through your urethra (which may be uncomfortable when it is placed, but should not be painful). Yu will have an IV in your arm or hand. Your belly will be washed and any hair between the bellybutton and pubic bone shaved. A privacy screen will be put around your lower body.

After delivering the baby the obstetrician removes the placenta from the uterus, closes the uterus with dissolvable stitches, and closes the abdominal incision with stitches or surgical staples that are usually removed, painlessly, a few days later. The babies vital signs will be checked and any necessary procedures like suctioning carries out.
When the baby is ok, you will be able hold and nurse your newborn in the recovery room. Because of the incision this will probably be lying on your side because holding your baby can put too much pressure on your fresh incision.

Here is a video explanation of a c-section delivery that I found. It’s an animation.

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Related posts:

1. Reasons for a C-Section
2. C-Section – Potential Risks
3. Post C Section Pain Control