Notes on Women's Health
Notes on Women's Health

6 Reasons a Cesarean (C-Section) May be Necessary

Baby feet with pink ribbonA Cesarean section, more commonly known as a C-section, is a method of delivery that involves making an incision through a woman’s lower abdomen and into her uterus to deliver the infant. C-sections are very common. In fact, data from the Centers for Disease Control and Prevention (CDC) shows that 31.9% of all recorded US births in 2016 were by C-section. This figure means that roughly one in three deliveries occurred via C-section.

When a C-Section May be Medically Necessary

Worldwide C-sections have saved the lives and preserved the health of hundreds of thousands of babies and mothers when they are medically necessary. Following our instances where a c-section may be required:

  1. Failure to Progress during Labor

During labor contractions dilate the cervix to allow the baby to pass from the uterus (womb) into the birth canal. The duration of the labor process is different for each woman and depends upon a variety of factors including previous births and the size of the baby. Sometimes, labor fails to progress. This means that the cervix does not open sufficiently to allow the infant to pass.

When this occurs, a C-section may be the best choice for delivery as both mothers and their babies can suffer ill effects from prolonged labor. A C-section will allow for a swifter delivery so that mother and child can begin to rest and recover.

  1. Fetal Distress

The term fetal distress encompasses a range of potential problems. Doctors monitor the baby’s vital signs during labor, and this information can let them know if the baby is having difficulties. These difficulties may be caused by a problem with the umbilical cord or other issues. For example, indications that the baby is not getting enough oxygen or the heart rate is too slow or fast may trigger the decision to perform a C-section. Once the baby is delivered, the physicians will be better able to offer care for any problems.

  1. Breech Presentation

During a normal vaginal delivery, the baby is in cephalic presentation – or head first. Breech presentation – or a breech birth – means that the baby is oriented so that it will exit the vagina feet-first or buttocks-first. Breech presentation is rare in full-term births, as about 97% of deliveries at 37 weeks or later are in the cephalic presentation.

Also, OB-GYNs can often perform maneuvers to help move a breech baby into the cephalic presentation. However, if these efforts fail and there is a danger to mother or baby, a C-section may be necessary.

  1. Large Babies

Sometimes a mother’s pelvis is simply too small to accommodate the passage of a large baby. In such a situation, a C-section can help to avoid harm to both mother and baby that could otherwise occur with a vaginal birth.

Additionally, a C-section may be required during the birth of multiples. Although twins can often undergo a successful vaginal delivery, triplets or more multiples usually need a C-section birth.

  1. Maternal Infections

Certain maternal infections may make a Cesarean delivery a safer option for the baby. For example, if a mother has HIV or genital herpes, these infections may be passed on to the child from a vaginal birth. A C-section delivery reduces the chances of the baby contracting these infections during birth.

  1. Placental Problems

The placenta connects to the baby’s umbilicus (belly button) via the umbilical cord. It supplies the fetus with nutrition and oxygen. The vast majority of pregnancies see no issues with the placenta, but problems can occur.

One such problem is placental abruption. This is the term for the separation of the placenta from the uterine lining. It usually occurs late in pregnancy and only about 1% of mothers. Placental abruption is characterized by pain and bleeding, and the condition often necessitates an urgent C-section.

Placenta previa is another possible issue that may require the need for a C-section. In this condition, the placenta is situated abnormally low in the uterus. As a result, the placenta partially or completely covers the cervix – blocking the opening. Depending on the degree of obstruction, a vaginal birth may be a possibility or a C-section might be a safer option. Placenta previa occurs in only about 0.5% of all pregnancies.

In any case, leading up to your due date you and your obstetrician will discuss your birth plan and any specific needs or situations that may impact your delivery, including the possibility of a c-section. The more educated and prepared you are going into labor, the more comfortable you can be in the process so that you can stay focused on the well being of you and your baby. So I encourage you to ask your OBGYN as many questions as needed in order to help you feel as prepared as possible for your birthing experience.


Dr. John Garofalo, M.D., is an OBGYN located in Fairfield County, Connecticut, providing care for Norwalk, Darien, New Canaan, Weston, Rowaytan and the surrounding areas. He has more than 20 years of practice and surgical experience covering many facets of obstetrics and gynecology.

Laury Berkwitt, APRN, is a nurse practitioner specializing in women’s health in Fairfield County, Connecticut. Laury has a passion for providing quality women’s healthcare in a safe and comfortable manner by creating a trusting patient-practitioner relationship. She has been in practice for more than 10 years, caring for women of all ages.

For more information, go to www.garofaloobgyn.com. John Garofalo, M.D., and Laury Berkwitt, APRN, can be reached for personal consultations by calling 203.803.1098.