Understanding Complications in Labor

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  What Every Pregnant Woman
  Needs to Know About Cesarean

Listening to Mothers II Survey

Sometimes there are problems in pregnancy, labor, and birth. Learning about them will help you make informed decisions if a complication occurs.

What if labor doesn't start on its own?

When pregnancy goes beyond 40 weeks, labor is considered overdue. If the date of conception was not calculated correctly, your labor may not be overdue at all. And some women have longer pregnancies and give birth safely at 42 weeks. At 41 weeks your health care provider may want to conduct certain tests like a biophysical profile (a special ultrasound scan) to make sure the baby is continuing to get oxygen and nutrients through the placenta. Depending on the circumstances, your health care provider may recommend waiting for your labor to start on its own, or recommend inducing your labor. Labor can be induced in several ways, including natural methods like nipple stimulation, or artificial methods like rupturing the membranes (a painless procedure that pierces the amniotic sac), or administering drugs to stimulate contractions. If you find yourself in this situation, ask your health care provider to inform you about the risks and benefits associated with induction, and the alternatives to induction and their risks and benefits, including waiting for labor to start on its own.

How do I know if I need a cesarean?

A cesarean section is major abdominal surgery and involves many risks to mothers and babies. The best research shows that unless there is a clear, compelling medical need for a cesarean section, vaginal birth is the safest way for women to give birth and babies to be born. In a small number of cases, an emergency cesarean is needed for a situation that poses immediate danger to the life of a mother and/or her baby. In such a situation the benefits of the surgery may outweigh the risks.

The most common reasons for having a cesarean include:
  • Previous cesarean section
  • Prolonged labor or “failure to progress”
  • Baby in a buttocks- or feet-first position (breech) rather than in a head-first position
  • Multiple births

Other less common reasons for having a cesarean include:

  • Placenta problems such as placenta previa (the placenta lies across the opening of the uterus) and placenta abruptio (the placenta detaches from the uterus before the baby is born)
  • Baby is too large and may not be able to pass through the pelvis
  • Serious maternal health problems (such as heart disease, cancer, active genital herpes, or HIV/AIDS)
If your health care provider recommends a cesarean either before you go into labor or during labor, be sure that you and your partner clearly understand the reasons for the surgery, the risks and benefits involved, and what alternatives are available before making your decision. If you are in labor, you can talk the situation over with your health care provider before deciding to have a cesarean.

If you are not in labor, you will have plenty of time to talk to your health care provider and do your own research before making your decision whether to consent to a cesarean. For more information on reasons for cesareans, the benefits and risks of cesarean birth versus vaginal birth, and practical tips to avoid unnecessary cesareans, download a free copy of the consumer booklet, What Every Pregnant Woman Needs to Know About Cesarean Section.

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Childbirth Connection is a national not-for-profit organization founded in 1918 as Maternity Center Association. Our mission is to improve the quality of maternity care through research, education, advocacy and policy. Childbirth Connection promotes safe, effective and satisfying evidence-based maternity care and is a voice for the needs and interests of childbearing families.
Most recent page update: 9/9/2010