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C-Section: Will I Need One?

By Julia Cruz
Beth Israel Deaconess Medical Center correspondent


Cesarean births in the United States are at an all-time high. Nearly one-third of pregnant women in the U.S. delivered their babies by C-section in 2007, according to the most recent figures from the Centers for Disease Control and Prevention. All things being equal, this means that you have about a one in three chance of delivering your baby by C-section.

But don't worry. While some expectant moms would rather have a vaginal delivery, every situation is different and it's what is safest for baby and mother that matters most.

"The way you deliver the baby is less important than delivering a healthy baby," says Dr. Celeste Royce, an obstetrician at Beth Israel Deaconess Medical Center.

A Cesarean section (or C-section) is when the baby is delivered through a surgical opening in the mother's lower belly. And with surgery comes potential risk, so it's important to talk about the options with your doctor before you deliver.

Problems with Pregnancy

Sometimes an expectant mother will go into delivery knowing she will need a C-section. That is the case for women who develop placenta previa - where the placenta grows in the lowest part of the womb and covers all or part of the opening of the cervix.

The baby's position may also force a C-section. A breech baby (feet first) or transverse lie baby (shoulder or back covering the cervix) will also require a C-section for delivery.

Women who develop medical issues during pregnancy such as preeclampsia (pregnancy induced high-blood pressure) or diabetes are at higher risk of needing a C-section, but may be able to delivery vaginally.

"Most of the time for first-time mothers, the decision for C-section will be made during labor," notes Dr. Royce. "Reasons may include the baby not tolerating the stress of labor, the baby being too big, or the strength of the uterine contractions being inadequate to dilate the cervix."

Past C-Sections

If you've already had one C-section, chances are any future deliveries will also need to be Cesarean births, but it's not a given.

"The mantra used to be, 'once a C-section, always a C-section,'" notes Dr. Royce.
"But in the past 30 years, that has changed some."

Vaginal birth after cesarean (or VBAC) is an option for some women, but there is the potential for a ruptured uterus and other complications, so it's important to have medical personnel nearby who can perform an emergency C-section if necessary.

"The vast majority of women who have a C-section for their first baby will go on to have C-sections for any subsequent babies," notes Dr. Royce. "The risk of complication increases with each C-section, so if a woman wants a large family, she should definitely consider a trial of labor for her second baby if her doctor considers it safe to do so."

And that is the most important thing to know - you should discuss your delivery options with your doctor to know what is in the best interest of you and your unborn child.

"Safety is our top priority," stresses Dr. Royce. "We're all here to make sure we have a healthy, happy mom and baby."

Above content provided by Beth Israel Deaconess Medical Center. For advice about your medical care, consult your doctor.

Posted September 2012

Contact Information

Department of Obstetrics and Gynecology
Beth Israel Deaconess Medical Center
East Campus
330 Brookline Avenue
Boston, MA 02215
617-667-0475

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