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Cesarean Delivery - What and When?

As you near your due date, you might start wondering whether you should opt for a normal vaginal delivery or a Cesarean delivery. In order for you to make an informed decision and discuss things comfortably with your doctor, you might want to learn a bit more about what a C-section is and when it is usually performed.

What is it?
A Cesarean delivery, also known as a C-section, is a surgical procedure used to deliver your baby through an incision in your abdomen and uterus. Some C-sections are planned due to pregnancy complications or because you've had a previous C-section, but in many cases the need for a first-time C-section doesn't become obvious until labor has already started.

When is it performed?
Your doctor will recommend performing a C-section when it is more beneficial to you and your baby than a vaginal delivery, such as in the following cases:

• Stalled labor: If your labor is not progressing due to your cervix not opening enough despite strong contractions, or your baby's head is too big to pass through the birth canal, a C-section will be performed.
• Reduced oxygen supply to your baby: If your baby's monitored heartbeat suggests that it is not getting enough oxygen, or if there are worrisome changes in your baby's heartbeat, your doctor may recommend a C-section.
• Abnormal body position: If your baby is lying horizontally across your uterus or if it is in breech position, which is when its feet or buttocks enter the birth canal first, and your doctor can't maneuver it into a more favorable position pre-labor, then a C-section will be needed in order to reduce the risk of complications during birth. 
• Wrong head position: A C-section is necessary when the baby enters the birth canal chin up, as it might not fit through the pelvis. 
• Umbilical cord complications: If the umbilical cord is looped around your baby, enters your cervix before your baby, or is compressed by the uterus during contractions, your doctor will have to perform a C-section.
• Problematic placenta position: A C-section is necessary if your placenta is covering the opening of your cervix or if it detaches from your uterus before labor begins, creating complications that might hinder vaginal delivery.
• Multiple babies: It is common for one or more babies to be in an abnormal position in the case of a multiple pregnancy where you are carrying two or more babies. A C-section would be a safer option in this case. 
• Health problems: When the mother suffers from a health condition such as diabetes or heart disease, the doctor might induce labor to reduce the risk of delivery complications, and sometimes a C-section will be needed. A C-section will also be chosen if the baby has a developmental problem such as spina bifida or excess hydrocephalus.
• Large baby: You will need a C-section if your baby is too big to safely undergo a vaginal delivery. 
• Previous C-section: A C-section might be recommended if you’ve had one before and your doctor feels that a vaginal delivery might not be successful either due to the incision type used in your previous C-section or due to other factors. 
• Personal choice: Some first-time expectant mothers simply request elective C-sections in order to avoid labor pain or complications associated with vaginal birth. Your doctor will be able to advise you on whether you can safely opt for a C-section if you would like to forgo a vaginal delivery.