While many different studies have shown that having a birth doula reduces the chance of having a cesarean, that is not always the case. When a cesarean happens, a birth occurs through an incision in the mother’s abdominal wall and uterus rather than vaginally. Recent reports from the Center for Disease Control show that the number of cesarean births are on the rise, which means that more than 1 in every 4 women is likely to experience a cesarean delivery.
What are the reasons for more and more women having to have a cesarean delivery? There are many different reasons why an expectant mother’s healthcare provider might recommend a cesarean. Other situations don’t give the mother the option, such as, critical situations where it is imperative to get the baby out as quickly as possible. And still, other women elect to have a cesarean versus trying to have their baby vaginally. Below are some of the most common reasons women have cesarean deliveries.
Placenta previa: This occurs when the placenta is low in the uterus and partially or completely covering the cervix. One in every 200 pregnant women will experience placenta previa during their third trimester. Treatment of placenta previa includes being placed on bed rest and frequent monitoring. A partial or complete placenta previa means that a cesarean is necessary. If only a marginal placenta previa is detected, a vaginal delivery may still be possible.
Placental abruption: This occurs when the placenta separates from the uterine lining. This generally occurs during the third trimester. Approximately only 1% of pregnant women will experience placental abruption. When this occurs, the mother will experience bleeding from the site of the separation, and pain in the uterus. The separation can interfere with the baby’s supply of oxygen. Depending on the severity of the separation, an emergency cesarean may be necessary.
Uterine rupture: Uterine rupture is cause for an immediate cesarean, as the results could cause hemorrhaging in the mother and interference with the baby’s oxygen supply. This occurs in 1 out of every 1,500 births where the uterus tears during pregnancy or labor.
Breech positioning: When a baby is in the breech position, often times a cesarean is the only option. Under certain circumstances a vaginal delivery can still happen. If the baby is in distress or has cord prolapse (which is common in breech babies), a cesarean is necessary. If the baby is premature, a cesarean may also be done to help deliver the baby safely.
Cord prolapse: While this condition is uncommon, when it does occur, an emergency cesarean is performed. Cord prolapse is when the umbilical cord slips through the cervix and protrudes from the vagina before the baby is born. When the uterus contracts, this places pressure on the umbilical cord that is protruding out, which then diminishes the blood flow from the mother to the baby.
Cephalopelvic Disproportion (CPD): CPD is when the baby’s head is too large, or the mother’s pelvis is too small to allow for the baby to pass through.
Preeclampsia: This is a condition that occurs during pregnancy and involves high blood pressure. As a result, the placenta could be prevented from receiving the proper amount of blood needed, or decreases the oxygen flow to the baby. As a treatment of preeclampsia, delivery is sometimes recommended. Only in cases of severe preeclampsia is a cesarean required.
Multiple births: Expectant mothers who are carrying twins or any set of multiples may require a cesarean delivery. Twins may be delivered vaginally depending on their positioning, estimated weights, and gestational age. Multiples of three or more are most likely going to be required to be delivered via cesarean.
While these are not all of the reasons that require cesarean delivery, cesareans are not uncommon. A birth doula will be able to help an expectant mother prepare for a cesarean, and help to calm their fears and anxiety about the procedure.
Author: Aliza Juliette Bancoff
Aliza Juliette Bancoff is a well-known doula and doula trainer who has been providing doula services to families for over a decade. She is the founder of Main Line Doulas, a doula group providing doula support in the great Philadelphia area for the last decade, the International Doula Institute, which provides online doula training and lactation training and certification programs and the International Breastfeeding Institute which provides lactation training and certification. She is the co-founder of United Birth, a company devoted to increasing access to doulas across the country to make the perinatal time safer both physically and emotionally. “Every birthing person deserves access to quality doula support. And we are working to make that a reality across the country. The work we are doing to get doulas to every birthing person will decrease the black infant and maternal mortality rate significantly by 2030.” Says Bancoff. Aliza is known for her compassionate and empowering approach to doula work, and she has been featured in numerous media outlets, including United Nations Maternal Health Report, Parent Magazine, CafeMom, theBump and many more. Aliza's journey into doula work began when she gave birth to her first child and felt a strong calling...