Reasons for Scheduled Cesarean Sections

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About one-third of all babies in the United States are born by cesarean section, also known as c-section. That is a lot of babies being born surgically. The risks to mother and baby can be greater with a cesarean, which has led major medical organizations, including the Society of Maternal Fetal Medicine (SMFM) and the American College of Obstetricians and Gynecologists (ACOG), to create guidance to help safely reduce the number of first cesareans. So why would you need a scheduled cesarean section? What are the most common reasons for this to be decided even before labor begins?

Reasons for Cesarean Scheduling Before Labor

There are different reasons that you may have a scheduled cesarean section prior to labor or at the beginning of labor. Most of these reasons have to do with the safety of the mother and/or the baby. These include, but are not limited to:

  • Placenta previa: In this condition, the placenta is near or covering the cervix. This blocks the pathway for a vaginal birth or would present a bleeding risk during labor.
  • Certain fetal positions: Your baby's position in the uterus may mean that vaginal birth is not possible, nor safe for them to be born. This can include transverse lie and some breech positions. Your doctor or midwife can talk to you about ways to encourage baby into a better position, but this is not always possible, nor successful.
  • Higher-order multiples: With every baby in the uterus the risk of a cesarean birth increases. While some twins and triplets are born vaginally, the more babies, the less likely a vaginal birth will be possible. This is many times due to odd positions in the uterus.
  • Active maternal herpes: If you have herpes and you have an active lesion on your genitals, you may be encouraged to have a cesarean rather than delivery vaginally. This is to prevent transmission to your baby.

Other Reasons

These reasons are certainly not the only reasons to have a cesarean birth scheduled prior to labor. There are a multitude of reasons why a cesarean may be the best choice for you. A few other reasons that may mean a c-section is the safest route of birth can include:

  • Previous invasive uterine surgery, including a previous classical cesarean incision
  • Certain fetal conditions
  • Diseases that may make vaginal birth difficult, like a pulmonary or coronary disease of the mother
  • HIV-positive with a high viral load at the time of birth

When a scheduled cesarean is discussed, be sure to ask questions about the procedure, including why, what the benefits are, what the risks are and what alternatives there are for you and your family. You should also be sure to talk to your practitioner and explain how you feel about this decision. If this is something that you had really hoped to avoid, it can take a bit of time to emotionally adjust to the news. This doesn't mean that you are selfish or wrong, it's simply an adjustment period after a hard decision.

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  1. Caughey AB, Cahill AG, Guise J-M, Rouse DJ. Safe prevention of the primary cesarean delivery. Am J Obstet Gynecol. 2014;210(3):179-193. doi:10.1016/j.ajog.2014.01.026