If it's not possible for you to give birth to your baby vaginally, you will need an operation called a caesarean. This operation is also sometimes called a caesarean section.
You and your doctor may decide in advance it’s best for you to have a caesarean delivery. Or you may start giving birth vaginally and then need to have an emergency caesarean because of complications during labour. You may also need to have an emergency caesarean before you go into labour.
Some of the medical reasons why you may have a caesarean delivery are listed below.
- Labour has been going on for some time and isn't progressing.
- Your baby isn't getting enough oxygen, or there is another problem putting his or her health at risk - this is called fetal compromise or fetal distress.
- The placenta partly or completely covers your cervix (the neck of your womb). This is called placenta praevia.
- You are expecting more than one baby, for example twins or triplets.
- Your baby is lying with his or her feet first or bottom first, rather than with the head downwards which is the usual position for a vaginal birth. This is called a breech position. It makes giving birth vaginally more difficult or sometimes impossible.
- There is a high risk that you may have heavy bleeding if you have a vaginal delivery.
- You have an infection such as HIV or genital herpes simplex virus.
- You have had a previous caesarean delivery, although after one child it's often possible to have a vaginal delivery afterwards.
There are two main types of caesarean delivery.
In a lower uterine segment caesarean a cut is made across the lower part of your abdomen and womb, usually parallel to your bikini line. There is usually a smaller amount of blood lost with this type of caesarean and the scar that forms afterwards tends to be smaller and stronger.
In a classical caesarean a cut is made vertically down the middle of your womb. The cut through your abdomen may also be vertical or a bikini line cut may be used. You may only need this type of caesarean delivery if there are reasons why a cut can't be made in the lower segment of your womb, for example if you have fibroids or if your baby is very premature.
What are the alternatives?
If you are planning in advance to have a caesarean, it's important to be aware of the possible alternatives.
For example, it's sometimes possible to give birth vaginally if you are expecting twins, if your baby is in the breech position or if you have had a previous caesarean delivery.
A midwife or doctor can give you more information about the risks and benefits of both options.