Delayed Emergency C-Section
Under certain circumstances, delivery must take place immediately because of the presence of a dangerous maternal or fetal health issue. There are standards of care in place for when this occurs, and doctors must follow these standards. If an emergency C-section takes longer than 5 to 30 minutes to perform (depending on the circumstances) or if doctors prolong a labor for longer than is reasonable, it increases the risk of birth injury (1). Immediate C-section delivery is often necessary in cases of fetal distress, placenta previa, uterine rupture, cord prolapse, placental abruption, and failure to progress in labor.
When are emergency C-sections necessary?
There are many critical situations that can occur during labor and delivery that require an emergency C-section. Once recognized, the medical team must take immediate action to delivery the baby via C-section. The most common complications include (2):
- Fetal distress: Likely the most common indicator that an emergency c-section is necessary, fetal distress occurs when the baby’s heart rate drops significantly or stays at a low rate for a long period of time. Fetal distress can result from an epidural, a sudden drop in the mother’s blood pressure, or uncontrolled maternal bleeding from placental problems such as placental abruption (where the placenta separates from the uterine lining and interferes with the baby’s oxygen supply). Fetal distress can be a sign of oxygen deprivation, which if not very quickly addressed, can lead to a form of brain damage called hypoxic-ischemic encephalopathy.
- Placenta previa: This happens when the placenta is low in the uterus and is near or covering the cervix, oftentimes blocking the fetus’ passage out of the womb. This can cause hemorrhaging in the mother and oxygen deprivation in the fetus.
- Uterine rupture: In cases of uterine rupture, the uterus tears during labor and delivery. It’s estimated that this occurs in about 1 in every 1,200 births (3). A uterine rupture can lead to hemorrhaging and a lack of oxygen to the baby, so a prompt delivery is crucial.
- Cord prolapse: This happens when the umbilical cord exits the birth canal before the baby. Cord prolapse increases the chance of cord compression, in which the blood and oxygen supply to the baby is cut off. Prolonged cord compression can lead to permanent brain injury.
- Prolonged or arrested labor: Sometimes labor fails to progress, meaning that dilation of the cervix ceases and contractions slow or stop. If labor is arrested, medical professionals must be prepared to move on to an emergency c-section.
Emergency C-section protocol: 30 minutes from decision to incision
In a situation where time is critical and a delay in delivery can lead to permanent brain damage or infant death, a rapid response by medical staff is imperative. The American College of Obstetrics and Gynecology generally recommends that most emergency c-sections are performed within 30 minutes of the time that the decision for the surgery is made. It is also recognized, however, that there are certain obstetrical emergencies like cord prolapse, uterine rupture, and bradycardia (slow heart rate, usually below 60 beats per minute), that require a C-section to be performed much sooner than 30 minutes (1).
What happens if an emergency c-section isn’t performed in time?
If medical professionals delay in performing an emergency c-section, or if they fail to recognize the signs that an emergency c-section is necessary, serious and permanent injuries can occur. If the oxygen supply to the fetus is cut off for a prolonged period of time, brain injuries like hypoxic-ischemic encephalopathy and cerebral palsy can result. If these injuries occur because medical professionals failed to uphold the standards of care, it is medical malpractice.
Award-winning birth injury attorneys
From our location in Michigan, Reiter & Walsh, P.C. represents clients all over the United States. Our award-winning birth injury law firm has handled numerous birth injury and delayed C-section cases, and we have over 100 years of joint experience in this complex area of law. Our firm focuses solely on birth injury cases.
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Video: delayed C-sections, birth injuries, and cerebral palsy
Watch a video of Michigan cerebral palsy lawyers Jesse Reiter and Rebecca Walsh discussing how delayed emergency C-sections can cause prolonged birth asphyxia and birth injuries such as cerebral palsy.
How do you pronounce cesarean section?
Related articles and blogs from Reiter & Walsh ABC Law Centers
- “Emergency C-sections: When 30 minutes isn’t fast enough.”
- “C-section is safest delivery method for preterm breech infants.”
- Tashfeen, K., Patel, M., Hamdi, I. M., Al-Busaidi, I. H., & Al-Yarubi, M. N. (2017, February). Decision-to-Delivery Time Intervals in Emergency Caesarean Section Cases. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5380420/.
- Why Would I Need to Have an Emergency C-Section? (n.d.). Retrieved from https://www.webmd.com/baby/emergency-c-section#1.
- Uterine Rupture in Pregnancy: Overview, Rupture of the Unscarred Uterus, Previous Uterine Myomectomy and Uterine Rupture. (2018, July 05). Retrieved from https://reference.medscape.com/article/275854-overview.
The information presented above is intended only to be a general educational resource. It is not intended to be (and should not be interpreted as) medical advice.