12 causes for a Caesarean section

Know about the probable causes that could lead to a c-section or cesarean section.

Most women yearn for a normal delivery during labour despite the pain and the discomfort it could lead to. But a normal delivery might not always be the outcome of a healthy pregnancy. Sometimes a C-section or a cesarean section becomes inevitable to keep the mother and the baby safe from the complications of pregnancy and labour. 'A c-section is sometimes planned due to a medical condition that can harm the progression of a normal delivery or at times is decided on the labour table if the fetal or maternal health is at risk,' says Dr Pooja Mehta, consultant gynecologist Paras Hospital, Mumbai. Here are some of the probable causes that could lead to a cesarean section:

Fetal distress: In the labour room, the mother is constantly monitored by the doctor or the attendants at regular intervals. One basic thing that the team would keep track of is fetal movements or fetal heart beat. 'If fetal monitoring shows any abnormalities like a lower heart beat, chances are the baby isn't receiving enough oxygen inside the womb. This could lead to further complication and have adverse effect on the baby. In such a scenario an emergency C-section is initiated,' says Dr Mehta. Also if the water breaks and shows traces of meconium, that indicates that the fetus has passed stools inside the womb. 'This can pollute the amniotic liquid in which the baby floats. If the baby inhales the meconium it can lead to other problems in the lungs or the respiratory system. Hence a c-section becomes necessary,' says Dr Mehta.

A premature delivery: If your labour starts before time and you end up in the labour room for a delivery much before your expected delivery date to birth prematurely this could be done through a c-section. As your baby isn't positioned right or in great health to co-operate with you for a normal delivery. Know how to calculate your expected due date or EDD.

Multiple pregnancies: 'Women who are carrying twins or triplets can have troubles having a normal delivery most of the time,' informs Dr Mehta. Though a vaginal birth with twins is still possible depending on the position and gestation age but with multiples or triplets a vaginal delivery is less likely.

Preeclampsia: This is a condition that is denoted with high blood pressure in the expectant mum during pregnancy. If it remains uncontrolled, this condition can prevent the placenta from receiving enough blood and the baby from getting enough oxygen. 'Severe high BP in the mother can make a c-section inevitable. Not that a normal delivery cannot be planned or managed with controlled BP, but high BP makes normal delivery unfavourable and a c-section a necessity,' says Dr Mehta.

Fibroids: 'Fibroids in the mouth of the cervix can be an obstruction to normal delivery. If your pregnancy is managed well then a planned cesarean section would be the option for a safe and sound delivery,' says Dr Mehta.

Placenta Previa: In this condition the placenta lies low in the uterus and almost practically covers the cervix. Sometimes with the progression of the pregnancy the placenta might move up with proper rest, care and close monitoring. But if it doesn't a c-section is the best option for both the mother and the baby.

Placental abruption: This is a condition where the placenta separates from the wall of the uterine lining. This might happen sometime during the third trimester and can also result in spotting or 'show' that could indicate imminent labour too. 'This abruption interferes with the oxygen intake of the baby and can lead to an emergency c-section,' informs Dr Mehta.

Previous history of c-section: If you had a previous c-section you can opt for vaginal birth the second time or VBAC. But keep in mind that most of the time a vaginal birth after a c-section can lead to uterine rupture at the site of previous c-section, this could lead to an emergency c-section in the labour room. Talk to your doctor before hand to know if a vaginal birth after a c-section is right for you and prepare accordingly.

Position of the fetus: 'If the baby is in a horizontal position or in a breech position, often a c-section is done,' says Dr Mehta. Though a vaginal birth with a breech position baby is possible under certain circumstances but if it leads to fetal distress or low oxygen supply to the fetus, a c-section would be the wise decision.

Cord prolapse: Though a rare occurrence, at times the umbilical cord can slip through the cervix and protrude through the vagina before the baby, making a vaginal birth difficult. This again calls for an emergency c-section.

Cephalopelvic Disproportion (CPD): This is a condition where the mother's pelvis is smaller and so obstructs the baby's head to smoothly slide through the birth canal. This is often diagnosed at the birth table.

STD in the mother: 'If the mother is affected with infections like the HIV or herpes a c-section is generally advised to prevent the baby from getting infected with the same while passing through the birth canal,' says Dr Mehta.

Dilation problems: 'Sometimes even with intense labour pain the cervix might not open enough for the baby to descend through the vagina. This delay in dilation can also be a reason for an emergency c-section,' says Dr Mehta. Sometimes a stalled labour where pain disappears middle of an active labour can lead to a c-section too.

Other health crises: If you are diabetic or develop gestational diabetes chances are you might bear a large baby or have other complication. 'In such a case the head of the fetus might get stuck in the birth canal during a vaginal birth leading to a c-section,' says Dr Mehta.

Though these are the probable causes of going under the knife when in labour, there could be any other reason, condition or physiological reason for your doctor

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• Common mistakes woman make during pregnancy
• 7 common pregnancy complaints and how to dodge them
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