The health of the mother and baby play the crucial role in determining whether she actually needs a cesarean.
Common medical reasons for cesareans include
- Fetal malpresentation — when the baby is turned so that its feet or buttocks will come out first
- Pelvic disproportion — a birth canal that is unusually shaped or too small in relation to the size of the baby
- A previous c-section or other surgeries on the uterus — myomectomy
- Presence of an infection, like HIV or genital herpes.
- Having multiples — twins, triplets or more
- Presence of a chronic health condition, like diabetes or high blood pressure, that requires treatment
Be aware: hospitals love c-sections
Research suggests that time pressures in some hospitals may lead to more cesareans, especially since vaginal deliveries can take a great deal of time for the staff. If you are healthy and have a low-risk pregnancy, the hospital where you plan to deliver may determine your odds of cesarean more than any other factor.
Find out the cesarean rate of hospitals in your area. Normally if you don’t have a medical reason to determine that you’ll need cesareans, public hospitals will let you usually wait until you reach the time of labor. Private hospitals on the other side may let you choose or recommend a cesarean to save time, and resources, and to bill you or your insurance a little more.
A woman who has a strong preference for vaginal delivery but ends up with a cesarean may feel a sense of loss for the childbirth she hoped to experience. But it’s important to remember that there are times when a cesarean is the best and safest option for delivery.
Doing your homework about the quality of care may reassure you that your delivery method is determined for the right reasons.
Dr. Wanwadee Sapmee Panyakat, MD. (19 January 2019)