Mark your calendars for April, because April is Cesarean Awareness Month! This event seeks to educate the public about C-sections and to reduce the rate of unnecessary C-sections. We support this stance, and would like to add our own goals to this admirable stance: educating the public about when C-sections are necessary.
At Reiter & Walsh, P.C., many of our cases have involved situations where indicated C-sections (C-sections that were recommended according to current medical care standards) were not performed in a timely fashion, and we would like to provide a short digest about when C-sections are usually medically indicated, in order to clear up some of the confusion surrounding when C-sections are and are not necessary.
When are C-Sections Necessary?
C-sections are usually necessary when there is a substantial risk of harm to either the mother or child with a vaginal birth. This is especially true with emergency C-sections because emergency C-sections are performed only in cases where the risk of harm is immediate and impending.
There are guidelines in place to evaluate when a C-section is necessary. If a C-section is delayed or done improperly, it is far more likely that the baby will have a birth injury due to birth asphyxia/hypoxic ischemic encephalopathy (HIE). Moreover, emergency C-sections must occur within 30 minutes or less to minimize the risk of damage to the baby.
What are Some of the Cases Where a C-Section is Recommended?
While each medical case is by its nature very different, there are some health issues that doctors can detect that indicate that a C-Section might be needed. These include:
- Baby in breech or face presentation: If the baby is positioned incorrectly for delivery, this vastly increases the chances that the umbilical cord may become compressed, resulting in a decreased flow of oxygen and nutrients to the baby.
- Macrosomia and cephalopelvic disproportion (CPD): If the baby’s head is too large to fit through the mother’s pelvis (either because the baby is large for its gestational age, or because the mother’s pelvis is small), it is often recommended that delivery occur through C-Section to prevent trauma to the baby’s head. Failure to progress in labor is also an indicator for a C-Section.
- Infection in the mother: There is a wide range of infections that mothers may have, including Group B Strep (GBS) and herpes, which might not harm the mother but can have devastating consequences for the child. If a mother has an uncontrolled infection when her water breaks, it is possible that the infection with be passed to the baby. Because the baby’s immune system is still very weak, the infection can cause damage.
- Placenta Previa: When the placenta covers part of the cervix, a vaginal delivery may cause massive hemorrhaging and blood loss in the mother, along with oxygen deprivation in the child due to this blood loss. It is generally safer to perform a C-Section in cases of placenta previa, especially when the placenta is completely covering the cervix.
- Placental abruption: If the placenta detaches from the uterus before labor, this means that the baby’s oxygen supply is cut off and the mother is at risk for serious bleeding (hemorrhage) and the need for blood transfusion.
- Umbilical cord complications: If the cord prolapses (enters the birth canal before the baby), has true knots cutting off blood flow to the baby, or is abnormally short, these pose a major risk for complications relating to oxygen deprivation for the baby.
- Preeclampsia: When the mother has severely high blood pressure during pregnancy, this can lead to seizures and end-organ failure in the mother, as well as oxygen deprivation in the baby.
It is important to remember that the medical situations of every mother and child are very different. It is admirable to take a stance to reduce unnecessary C-Section rates but just as equally important to remember that C-sections can often be necessary to prevent birth injuries and health complications for both the mother and child.
As birth injury lawyers, we have often seen that medical negligence can lead to delayed C-sections that violate the required standard of care — cases where C-sections were mandated by medical practice and not carried out. We urge readers to explore our site to educate themselves about C-sections and the birth injuries that C-sections can help reduce and prevent.