Cesarean deliveries, or C-sections, are performed for many reasons/indications. Cesareans can be scheduled, or urgent/emergent. The need for a cesarean arising from circumstances in labor are usually performed on an urgent basis, and less frequently on an emergency basis. This discussion is about cesareans that are planned weeks to months in advance, and therefore called scheduled cesareans.
Some of the reasons for a scheduled cesarean delivery are a breech presentation, a prior history of cesarean, or a history of myomectomy or complicated prior pelvic surgery. Scheduled cesareans can also occur if a patient has a strong preference for cesarean assuming they plan on having a smaller family. Other reasons might be age related; as women age their likelihood of delivering vaginally also decreases, therefore they may opt for a scheduled delivery. Literature also supports that women with elevated Body Mass Indexes (BMI) over 30 are more likely to have a cesarean. Women with prior cesareans may wish to reduce their risk of a wound infection by avoiding labor and scheduling a repeat cesarean. These are a few examples of common reasons for scheduling a cesarean delivery. Each patients risk, and their choices are unique, and this warrants adequate counseling. We promote vaginal deliveries and a trial of labor for most patients.
A scheduled C-section is a scheduled appointment to deliver a baby by cesarean, usually in the week prior to her due date. As mentioned above, this is chosen after detailed counseling with your provider addressing the risk and benefits of the procedure. Scheduled cesareans are assigned a date and time for delivery. Since the Labor and Delivery unit also cares for women in labor, the timing can change as other patients may have an urgent – or emergent – need to be delivered, and the time can be delayed. Delay from your scheduled time typically happens less than 20% of the time.
Some twin, or multiple pregnancies, are most appropriately delivered by cesarean when the first (presenting) baby is in a breech presentation. Placental previa, where the placenta is blocking the birth canal, is also a reason for a cesarean delivery. Prior significant uterine surgery, such as to remove fibroids or a classical cesarean delivery, are also reasons for cesarean delivery.
Mothers can also additionally elect to have a cesarean section. Your doctor will explain the risks and benefits associated with this surgery, and together you can decide what is best for you. At MFMA, it is a rare occurrence that a patient voluntarily asks for a C-section, but it does happen occasionally.
In general, natural birth is safer or better for the mother and baby than cesarean sections. Equally important is the need to avoid complications during childbirth. In general, an uncomplicated vaginal delivery is easier than an uncomplicated cesarean delivery. However a complicated vaginal delivery can often be more difficult than an uncomplicated cesarean delivery. Some complications are avoidable, and some are not. At MFMA, we strive to discuss each woman’s risk with her, and try to work collaboratively to guide a patient along the least complicated path possible in their journey through childbirth. The discussion starts in the office and continues throughout the labor process. It is a complicated journey, with lots of considerations and factors.
With a scheduled Cesarean delivery, you can prepare for the procedure. Anesthesiologists require fasting for 8 hours before your surgery. You may drink clear fluids (liquids that you can literally see through and are not cloudy) up to 2 hours before your surgery. Your partner or loved one can help you during your short hospital stay, so make sure they’re familiar with where to park and which entrance to use.
We instruct patients to arrive two hours before their scheduled cesarean to be admitted, start an IV, and be interviewed by the team that consists of nursing, obstetric and anesthesia staff. Some people even prepare a musical playlist that some of our doctors play through a Bluetooth speaker in the operating room for a more comfortable experience of delivery.
Our doctors and maternal fetal medicine specialists strive to make sure you understand every aspect of your pregnancy and delivery experience, including choosing to undergo a cesarean section when it is required or preferred. We know this is a big decision, so we provide all the information we can to help you make an informed one. To learn more about your options for a scheduled cesarean section, please do not hesitate to call us or contact us online today.
Maternal Fetal Medicine blogs are intended for educational purposes only and do not replace certified professional care. Medical conditions vary and change frequently. Please ask your doctor any questions you may have regarding your condition to receive a proper diagnosis or risk analysis. Thank you!