 There are many reasons why a woman may require a Cesarean birth. If that is the situation, your physician will discuss the options with you. Cesarean sections are performed adjacent to Labor and Delivery in an Operating suit, fathers/ partners are allowed to be present during cesarean births. The patient is prepped for surgery and when ready the partner is called in to support the mom and be present at the birth.
At Saint Barnabas a neonatologist, a physician who specialized in the medical care of a newborn infant, attends all cesarean births. While most insurance companies provide coverage for this service, you may want to check with your individual carrier.
A Cesarean Section Question and Answer
Sheet from
the New Jersey Hospital Association
What
is a Cesarean Section?
A c-section is the surgical delivery of a baby through an incision
(cut) in the abdomen and uterus. C-sections should be performed
only when considered safer––for both mother and baby––than
a vaginal delivery.
Why would a Cesarean Section be necessary?
There are many reasons why a c-section may be done.
They include:
- Size - The baby is too large to fit through the mother’s
pelvis.
- Stalled Labor - Labor does not progress, putting mother
or baby at risk. Many physicians are now practicing “active
management of labor”––protocol that determines
what should happen at each phase of labor. If the labor is not
progressing accordingly physicians then stimulate labor through
physiological intervention or medication before opting for a
c-section.
- Abnormal Positioning - Sometimes the baby’s
head is not the first part to appear in the birth canal. Shoulders,
buttocks or other body parts can appear first, making vaginal
delivery more difficult. More and more often, in cases where
an unusual position is detected prior to labor, physicians are
trying to turn the baby––using their hands on the
mother’s abdomen.
- Medical complications - If the mother has a severe
infection, diabetes, heart disease, high blood pressure or other
health problem.
- Fetal Distress - The baby is in danger––has
an erratic heart rate or is not getting enough oxygen.
- Multiple Births – Sometimes––but
not always––twins, or more than two infants, can
complicate delivery
- Problems with the Placenta - If the placenta (afterbirth)
is bleeding, or if it is positioned to exit the uterus before
the baby does or if it is over the opening of the birth canal
(placenta previa).
- Cord Prolapse - The baby’s umbilical cord falls
through the birth canal.
- Late Child Bearing - Many women are delaying pregnancy
until later in life when the risk of complications is higher.
Who determines if a C-Section is necessary?
Your physician or midwife; but you should be part of the decision
too. You should take an active role by talking with your physician
or midwife and asking specific questions such as when a c-section
would be recommended; what steps would be taken prior to performing
a c-section; whether to seek a second opinion; and whether vaginal
delivery is encouraged after a previous c-section. It is important
that you feel comfortable with the views of your physician or midwife
on c-section deliveries.
Is it possible to deliver vaginally after a C-Section?
Yes. The procedure is known as VBAC, or vaginal birth after cesarean.
Some physicians used to feel that “once a cesarean section,
always a cesarean section,” fearing that the scar on the
uterus may rupture during a vaginal delivery. However, new ways
of performing the c-section operation have greatly reduced the
risks of that happening. One of the greatest obstacles associated
with VBACs is fear by women that they “can’t do it.” Some
women––tired of being pregnant, fearful of vaginal
delivery after a previous c-section, or simply looking for the
convenience of a “scheduled” delivery––will
request a c-section. But the truth is that women who have had repeat
c-sections experience more complications than women who deliver
by VBAC. Together, with your physician or midwife, you should discuss
if a VBAC is a good choice for you.
What can I expect in terms of recovery? Will I have a
permanent scar?
Again, it’s important to remember that a c-section is major
abdominal surgery, and the recovery period is that of any major
operation. One common side effect of c-section delivery is gas
pain, resulting from opening the abdominal cavity and uterus. These
pains may occur in the abdomen, back, even shoulders, and in some
women are quite severe. You can expect a permanent scar, which
in most cases, will be small and horizontal. The recuperation period
from a c-section is much longer than that of a vaginal delivery.
Is it more expensive to deliver by Cesarean?
Typically the cost for c-section delivery is higher due to additional
expenses, a longer hospital stay and extended recuperation period.
In New Jersey women who deliver by c-section are entitled, by law,
to remain in the hospital for 96 hours.
What is a Cesarean Section rate and how is it determined?
There are two types of c-section rates that measure how frequently
c-sections are performed––total c-section rates and
primary c-section rates. The total c-section rate is determined
by dividing the number of cesarean sections by the total number
of deliveries for a specific period. This is the rate typically
published in newspaper and consumer reports.
The primary c-section rate is considered more accurate because
it looks at first-time c-sections, thereby ruling out patient preference.
The primary c-section rate is determined by dividing the number
of women having a c-section for the first time by the total number
of deliveries by women who have never had a c-section. Women who
have had repeat c-sections or VBACs are not included in primary
c-section rates.
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