Emergency Caesar

We have a secret in our culture, and it's not that birth is painful. It's that women are strong.
Laura Stavoe Harm 

For an expectant mom who has planned a natural birth down to the last detail, the thought of needing to deliver via Caesarean is nothing short of horrific. Nevertheless, sometimes an emergency Caesarean is necessary no matter how meticulous the planning has been; no matter how good the intentions of everyone involved. Understanding the facts surrounding emergency Caesareans can make the experience much easier to accept.

A Caesarean delivery (or C-section) is a birth that takes place by making an incision in the abdominal wall and uterus rather than the baby being delivered vaginally. Exactly what is an emergency Caesarean? As opposed to an elective Caesarean, which is carried out before labour begins, an emergency Caesarean is carried out due to complications arising during labour that place either mother or baby at risk. It is important to realise that emergency Caesareans do not only take place when the situation has already become critical but also when there is reason to believe that a C-section would prevent a critical situation from arising.

There are several reasons why an emergency Caesarean may become necessary:

• Foetal distress– a baby is considered ‘distressed’ when foetal monitoring indicates that he is not receiving enough oxygen.
• Unprogressive labour – if labour slows down or stops during the second phase before the cervix is fully dilated, an emergency Caesarean may be necessary to prevent baby and mother from becoming exhausted.
• Placental abruption – if the placenta starts to separate from the wall of the uterus there is a risk of haemorrhage and loss of oxygen to the baby. Placental abruption only occurs in approximately 1% of all pregnant women.
• Uterine rupture – should the uterus tear during pregnancy or labour the mother is at risk of haemorrhaging and the baby’s oxygen supply will be compromised. Uterine rupture is also not a very common occurrence.
• Cord prolapse – very rarely the umbilical cord will slip through the cervix and protrude from the vagina before the baby is born. Blood flow to the baby is diminished when the uterus contracts and places pressure on the umbilical cord.
• Size – the situation may arise that the pelvis is too small to allow the baby through. This will often have been determined before hand, resulting in an elective Caesarean being chosen.

Remember that the end justifies the means and needing an emergency Caesarean is not in any way a failure on your part – the most important thing is that mom and baby leave the labour ward healthy.