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Dr Marlena du Toit

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Information on Caesarean section

Definitions and terminology

A Caesarean section is a surgical procedure to deliver a baby through an incision in the mother’s abdomen. A caesarean section is need when delivery of the baby through the birth canal (vagina) is not possible or when vaginal delivery pose a danger to the mother or the baby.

A caesarean section can be planned in advance as an elective procedure or it may be performed as an emergency if a serious complication that may harm the mother or the baby develops during labour. It may also be performed during labour if it becomes likely that a vaginal delivery will not occur without a high risk or harmful factor present. In such a case it is part of safe obstetric practise and not classified as an emergency caesarean section.

Indications for a caesarean section

Elective

  • The estimate weight of the fetus exceeds 4.0-4.5 kg.
  • The birth canal could be partially or completely obstructed by the placenta (afterbirth) – a condition known as placenta praevia.
  • The baby presents as a breech – the buttocks lies at the bottom of the uterus.
  • The mother is suffering from an active vaginal infection – like Herpes which can be transmitted to the baby in the birth canal.
  • The mother had a previous caesarean section and wishes not to have a trial labour. If the mother wishes to continue with an attempt to have a vaginal delivery, she will be monitored meticulously and the obstetrical will advice on a caesarean section if necessary.
  • If there is concerns about the baby’s health during the antenatal period and the obstetrician believe that the baby will not cope with the stresses of vaginal delivery a caesarean section will be advised.
  • In specific medical conditions a vaginal delivery is contraindicated.
  • If the mother requests a caesarean section due to her own fears of beliefs, it will be performed. Patients are encouraged to discuss this with the obstetrician before making a final decision due to future consequences.

Emergency

  • During the labour process the fetal monitoring may suggest fetal distress and in such circumstances an emergency section may be the better option.
  • If the placenta partially separates from the uterus before the birth of the baby – a condition known as Abruptio Placentae.
  • In some cases mothers suffering from a medical condition where vaginal birth is not contraindicated, the situation may change during the birth process and the safest option may be a caesarean section.
  • In the case of fetal distress or poor progress or deterioration in the fetal condition a caesarean section may be the quickest and safest route of delivery.