What Are The Reasons For Having A Caesarean Section?

The reasons for needing a caesarean section vary, because every pregnancy and birth is different. 

If you had complications in previous pregnancies or births, or in your current pregnancy, your doctor may advise you to have a planned caesarean, or a planned repeat caesarean. 


Reasons for needing a planned caesarean 

A planned (elective) caesarean may happen because:
You've already had a caesarean section, and there were complications during the procedure. If there were no complications, a vaginal birth after a caesarean (VBAC) may be possible, and is successful in 70 per cent of cases.
Your baby is in a bottom-down (breech) position, and external cephalic version (ECV) isn't recommended, or hasn't been successful.
You are expecting twins or more, and the first baby isn't in a head-down position.
Your baby is in a sideways (transverse) position, or keeps changing his position (unstable lie).
You have severe pre-eclampsia or eclampsia, and having your baby by vagina will take too long to be safe.
You have a low-lying placenta (placenta praevia).
You have a medical condition, such as a certain type of heart disease.
You've asked to have a caesarean, perhaps because of a previous traumatic vaginal birth.
You caught genital herpes for the first time in your third trimester.
You have HIV and are either not receiving retroviral therapy, have a high viral load, or also have hepatitis C. A vaginal birth is an option if your HIV is under control.

Sometimes, certain conditions go together, giving more than one reason to have a planned caesarean. For example, you may have a low-lying placenta that has contributed to your baby settling into a breech or transverse position. 

Reasons for needing an emergency or unplanned caesarean 

Occasionally, medical staff will move quickly to operate, so that your baby can be born safely (emergency caesarean). This may happen if:
Your baby becomes distressed during labour.
Your labour is long and slow (failure to progress) as your cervix isn't opening enough to allow your baby to move down the birth canal.
There has been an unsuccessful attempt using instruments such as forceps or ventouse.
The placenta has come adrift in late pregnancy or during labour (placental abruption), which puts you and your baby in danger.
A scar from a previous caesarean tears (uterine rupture). This happens to one in 200 women, though, so isn't common.
The umbilical cord slips through your cervix ahead of your baby (prolapse of the cord). This uncommon complication means that there's a danger that the cord will be squashed as your baby descends, cutting off your baby's oxygen supply.

In many cases, a caesarean happens for clear health reasons, and is the safest option for mum and baby. Sometimes, though, the decision to operate is based on information that is open to interpretation, or reflects the skill or experience of your obstetrician. This means that decisions can vary from hospital to hospital.

Talk to your doctor to find out more about your particular case. Always ask for a second opinion if you are unsure if the decision is right for you.