"Best of" Week: Enjoy Birth

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Types of Cesareans

There seems to be an epidemic of Emergency Cesareans.  When I talk with moms, or read birth stories, many label their cesareans as emergency’s.  But as I ask questions or as I read details, I see that it wasn’t a true medical emergency, but mom has been led to believe it was.  Even my cesarean, which I have always called an emergency cesarean, really was ‘urgent’, not an ‘emergency’, the difference being the timing. 

Is it just a lack of good definitions for the types of cesareans?  I think in many people’s minds it is either a

 planned cesarean = non-emergency

or

un-planned = emergency.

 

 I have come up with more descriptive labels.  What do you think?  Do you have any to add? 

 

Planned Cesareans: 

 
Elective – mother chooses without a medical reason.  For example: fear of pain.

Care Provider or Mother Convenience – Sometimes care providers will even suggest a cesarean for convenience for him or the mom. 

Medically indicated – mother chooses for a good medical reason.  For example: complete placenta previa.

Care Provider Necessitated/Pressured – Some planned cesareans, may have questionable reasons.  For example:  twins; breech; or suspected big baby

Her OB says it is medically indicated so mom assumes it is, but if she was to do further research, she would find that she has other options.  Many care providers allow twin births, breech births, believe babies grow to the perfect size for the mothers, etc.

 

Unplanned Cesareans: 

Emergency due to natural causes – A life threatening situation to mom or baby.  Time from decision to surgery would be less than 10 minutes.  For example: placental abruption.

Emergency due to interventions – A life threatening situation to mom or baby.  Time from decision to surgery would be less than 10 minutes.  For example:  Breaking of water causes cord to prolapse

Urgent due to natural causes  - Medically indicated, but not currently life threatening. Typically the time from decision to surgery would be 20-60 minutes.  For example:  baby is showing distress due to cord issues.

Urgent due to interventions  - Medically indicated, but not currently life threatening.  Typically the time from decision to surgery would be 20-60 minutes.  For example: pitocin induced contractions causing distress to baby

Maternal Choice due to natural causes  – For example:  mother’s intuition (mother senses something is wrong and upon delivery indeed there is an issue.)

Maternal Choice due to interventions  – For example:  not allowing food causes mom to feel nauseous and exhausted. 

Failure to Progress (or Failure toWait) – progress may be slower than anticipated but mom and baby are doing fine.   OB is ready to go home, or hospital has arbitrary “guidelines”.  For example: mom can only push 2 hours. 

Failed Induction – Your body was not ready to give birth or baby was not ready to be born. 

Often the care provider blames it on mom or baby.  For example, “Oh this baby was just too big or your pelvis was too small. “   This can be damaging to mom, who may think her body doesn’t “work”  Let’s say what it really is, your body and or your baby were not ready.   Or more simply the induction did not work. 

Reluctant Mother Choice / Nothing Else Seems to be Working - This is for moms who have tried waiting hours, different positions.  Mom and baby are still doing fine, but (usually because of baby positioning) no progress is being made and mom is told this is the way baby is coming out.  So mom reluctantly goes forward. 

 

This post originally appeared on the Enjoy Birth blog on December 28, 2008 and was submitted by the author for “Best of” Week.

Sheridan is the mom of 3 boys, a VBAC mom, Hypnobabies Instructor and Hypno-doula.

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