A cesarean section is performed when natural childbirth is difficult and poses risks to the mother or the baby. However, not all cases require the procedure to be done mandatorily, and in many situations, the decision remains in the hands of the obstetrician. The main reasons and conditions that necessitate a cesarean section are:
1. Labor complications and factors that obstruct vaginal delivery, such as prolonged labor, uterine rupture, placental issues, ineffective labor contractions after several hours, the baby being in a transverse position making natural delivery difficult, the baby’s size exceeding 4 kg, a narrow maternal pelvis, umbilical cord complications like vasa previa or umbilical cord prolapse, fetal distress, and failed instrumental deliveries (using forceps or vacuum).
2. Other pregnancy complications or maternal illnesses, such as carrying multiple fetuses, maternal infection with HIV or sexually transmitted diseases like herpes that can be transmitted to the baby during vaginal delivery, previous uterine rupture, or a prior classical (vertical) cesarean section.
3. Other reasons include severe hemorrhaging during labor threatening the mother due to placental abruption, preeclampsia, prolonged pregnancy beyond 40 weeks without the onset of labor, uterine inertia, first-time mothers over the age of 35, or if the baby is highly desired after long-term infertility treatment. The rate of cesarean sections is relatively high in many countries, and doctors encourage reducing this rate effectively through:
Changing the definition of active labor onset from 4 cm to 6 cm of cervical dilation.
Allowing the mother to push for at least two hours if she has given birth before, or three hours if it is her first delivery, before considering labor as stalled.
Physical exercise during pregnancy reduces associated risks.
Dr. Ghufran Nasser Kareem
