Reasons for a C-Section: Planned and Unexpected

Cesarean sections are valid and lifesaving ways of giving birth.

Cesarean sections are quite common and occur in a little more than 32% of births in the United States, and in some areas, it is as high as 60%. The World Health Organization (WHO) recommends a much lower amount of 10-15% of births being delivered via cesarean section. With this recommendation, the United States has a long way to go.

As we talk about reasons for cesarean sections, it is essential to note that there is a difference between actual reasons for a surgical birth and reasons doctors in the United States use to encourage and push cesarean sections. It is crucial to remember that cesarean births can be lifesaving when used appropriately. On the other side of the coin, cesarean deliveries can be traumatic and life-altering or threatening when misused.

Why Might Doctors Opt For a Cesarean? 

First, let’s state why many doctors in the United States opt for cesarean section births. Some of the reasons given to clients are because they will have a big baby, which has been debunked, and most “big babies” come out around 7.5 lbs.

Multiple gestation is another reason that is commonly used for having a surgical birth. In some cases, this may be necessary, but multiples can be born vaginally just fine in many situations.

Malpresentation like breech, transverse, and military presentation are often used as a reason for a cesarean birth. Some of these positions indicate an impossibility of vaginal birth, but other positions can be delivered vaginally by a trained and competent provider.

Breech birth is the most commonly misunderstood presentation, and it is often assumed that breech births must come via cesarean section. Still, there are ways of safely delivering a breech baby vaginally, and most individuals lack the training and education.

Non-reassuring heart rate is another big reason individuals are rushed into emergency cesarean sections. Although this can be an excellent indicator that the baby is not tolerating labor and needs to be born faster, evidence also suggests partographs produce a high amount of false negative information. For parents in this situation, asking for an internal monitor can be a reasonable and safe request before going back for a cesarean birth.

Labor dystocia is another common reason that individuals have cesarean births. The problem with this diagnosis is that hospital timelines often have less to do with evidence on how labor goes in physiological birth and more to do with policy. Sometimes labor dystocia is wrongly diagnosed, and cesarean births occur without good evidence of them being necessary.
Another widespread recommendation is that if you have had a previous cesarean section, you must schedule your cesarean sections for all births after this. Vaginal birth after cesarean sections (VBAC) births are a generally safe choice depending on the reason for your last surgical birth and how many surgical births you have had up to this point. Getting more information can be helpful to know what feels best for you and this birth and baby.
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Trauma or Sexual Abuse

A critical reason for cesarean births is a history of sexual abuse and trauma. Sometimes individuals who have had this type of trauma can go on to have a normal vaginal delivery.
Still, in many cases, an epidural or cesarean section can be the most kind thing we offer to these birthing parents.

Some of the bravest parents that I know asked for a cesarean birth, and I genuinely believe that in doing so, they avoided the most amount of retraumatization.

Thinking To the Future

As you can see, with each of these reasons for cesarean birth, there is room for discussion and change to be made. Training doctors to know physiological birth is a significant first step. It is also essential for doctors and nurses to be able to step outside of their institutional box and try a few new things before going straight to surgical birth.

Choosing A Care Provider

But the most important thing is choosing a care provider you can trust to have your best interests in mind. Whether this is an OBGYN, hospital midwife, or community hospital midwife, you must trust that they are giving you the best possible advice for your situation.
You must also trust yourself to be the professional of your own body and baby. Care providers are professionals in childbirth, but you are a professional of your individual experience.

If there is something your care provider is recommending that you disagree with, speak up. It could just save your life. Like all decisions in childbirth, unless they are actively wheeling you back for surgery, you have time to sit with and think about your choices and decisions.

You will know when a true emergency is occurring, and until that moment, the floor is yours to decide how you will birth your baby or move forward in the situation that you are currently in.

Trust your inner knowing and begin a life of advocating for your child because that advocacy never stops.
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