most women and babies will have the best
outcome with a vaginal delivery
but we are fortunate to live in a time
and a place where a cesarean section
is safe and available if your pregnancy
or delivery requires surgery for the
safety of your baby
some women know ahead of time that they
will be having a planned cesarean
section
other women labor with the intent to
have a vaginal delivery
but turn out to need a cesarean section
for the safe delivery of their baby
if you have an indication for a plan
cesarean section your provider will
discuss this with you ahead of time
some reasons might include that the
placenta is in a dangerous location for
vaginal delivery
that the baby is not head down towards
the birth canal that there's a maternal
or fetal condition that makes it unsafe
to labor
or that it's a planned repeat caesarean
section
please note if you've had two or fewer
prior cesarean sections
you may be a candidate for a trial of
labor for a vaginal birth
known as a vbac please see our vbac
video for more details
even if you and your healthcare team are
working towards helping you to have a
vaginal delivery
there are sometimes reasons why a
cesarean section may ultimately be a
healthier way to deliver your baby
some of these reasons include fetal
heart rate concerns
during labor the heart rate is often
monitored to check the well-being of the
baby
while this type of monitoring is not
perfect and it's most appropriate for
use in higher risk women
it can give important information about
how much oxygen your baby is getting
during labor
labor is hard work for your baby as well
as for you like an exercise stress test
if there's concern that your baby is not
getting a sufficient oxygenation during
your labor
and you are not very close to delivering
vaginally it may be safer for your baby
to be delivered via cesarean section
failed induction if you need to be
induced for any reason but your body
does not respond to the medication used
to try to promote labor
a cesarean section may be recommended
for safe delivery
cervical dilation arrest when the cervix
is dilated
six centimeters or more active labor has
started
if the cervix does not continue to
dilate medications may be offered to
assist in continuing the labor to
progress
if the cervix still doesn't dilate
despite these medications
caesarean section will be offered for
safe delivery
baby unable to descend through the
pelvis once your cervix is fully dilated
your obstetrics team will help you begin
to push it can be normal to push for
hours especially with a first baby
however if the baby does not descend
through the birth canal with pushing
a cesarean delivery may be recommended
sometimes if the baby has come low
enough into the birth canal an assisted
vaginal delivery can be offered
with either a vacuum assist or a forceps
assist
an assisted vaginal delivery can only be
safely offered if your baby is low
enough in your pelvis
if your baby still doesn't deliver with
assistance then it's safest to proceed
quickly with a cesarean section
pushing can be an especially stressful
part of labor and sometimes the baby's
heart rate tracing may show
signs of distress depending on how close
you are to delivering this may prompt
your obstetrics provider to recommend
either an assisted vaginal delivery
or a cesarean section one question
patients ask me
is if their baby has its umbilical cord
wrapped around its neck
would that mean that they need a
cesarean section
babies are often born with their cord
wrapped around their neck and they can
frequently be born vaginally without
danger
however having the cord wrapped around
the baby's neck can increase the chances
that there's poor oxygenation while
pushing
which may result in the recommendation
for an assisted vaginal delivery
or cesarean section for the safety of
your baby
i continue to be inspired by the courage
and love that women have for their
children in their willingness
to undergo major surgery for their child
safety
making the recommendation for a cesarean
section should be done only with the
utmost
care uc san diego health providers take
this seriously
and we were named to the c-section honor
roll for meeting statewide targets for
reducing cesarean sections
it's part of our commitment to you and
your family to provide you with the
safest
possible delivery for healthy mom and
healthy baby
you