Elective and emergency Caesareans
There are two kinds of Caesarean. An elective Caesarean (sometimes called a ‘cold
section’ in medical jargon) means a Caesarean that is carried out before labour
begins. An emergency Caesarean is one that is carried out as a result of some complication
arising during labour. It may not necessarily be an emergency situation. Your carers may
have been discussing the possibility with you for some time before finally deciding that
it is necessary.
Your obstetrician might advise you to have an elective Caesarean if:
- You have serious pre-eclampsia
which is threatening your own health and the well-being of your baby
- You have a serious medical condition which means that you should avoid the stress of
labour
- You are expecting triplets, quadruplets or more
- The placenta is positioned across the neck of your womb, making it impossible for your
baby to be born vaginally
- Your baby is lying across your tummy and cannot be turned to a head down position
- Your baby is too big to be able to get through your pelvis
- Your baby is in the breech position. Whether all breech babies should be delivered by
Caesarean is a matter of debate. Some obstetricians prefer to turn babies into a head down
position at the end of pregnancy (this is called external cephalic version or ECV), or to
give the mother the chance to try for a vaginal delivery with her baby in the breech
position. If your baby is breech, discuss what you would like to happen with your
obstetrician and midwife. The research is currently unresolved about whether it is safer
to deliver breech babies vaginally or by Caesarean.
An emergency Caesarean might become necessary after labour has started because:
- Your baby’s heartbeat shows that he is not coping well with contractions (in
medical terms, the baby is described as being ‘distressed’)
- The cervix stops dilating or dilates very slowly so that both mother and baby become
exhausted
- The placenta starts to come away from the wall of the uterus and there is a risk of
haemorrhage (bleeding)
- The baby does not move down into the pelvis, indicating that the pelvis is too small for
the baby to get through
Whether you are offered an elective or an emergency Caesarean, make sure that you
understand the reasons why. Even in an emergency situation, there’s nearly always
time to give the mother and her birth partner a brief explanation of why a Caesarean is
considered necessary.
After your baby has been born, it’s a good idea to ask one of the midwives on the
postnatal ward or the midwife who comes to visit you at home to go through the reasons for
the Caesarean with you. Then, if you choose to have another baby, you will know whether
you are likely to need another Caesarean or not.
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