- Placenta Previa- A previa is when the placenta is covering all or part of the cervix. A complete previa covers the cervix completely, a partial means it is over part of the cervix. Clearly if the previa is complete, there is no way for the baby to come out vaginally and a c-section is required. With a partial there is still a high bleeding risk involved and will still require a c-section. Often times previas will move. The placenta need to be at least 2 cm away from the cervix for a vaginal delivery.
- Placental Abruption- This occurs when part of the placenta begins to tear away from the uterine wall before the delivery of a baby. Typically it comes on very suddenly and there is a lot of bleeding and pain. Due to the blood loss the baby needs to be delivered quickly for the health of both mom and baby.
- Prolapsed cord- This occurs when the umbilical cord comes down before the baby's head. This is an emergency and the baby needs to be delivered ASAP!
- Non-reassuring heart tones- This includes prolonged decelerations or persistent late decelerations that do not stop with intervention. A prolonged deceleration in the baby's heart rate is an emergency and you will be running back for a c-section. Late decelerations (slight decrease in heart rate that occurs after the contraction) is not an immediate emergency, but are a sign that there is a problem with the oxygen supply to the baby. Other interventions would be attempted before a c-section, but if there is no improvement a c-section will be needed.
- Breech or Transverse Presentation- I mention these here because there are not many providers who will deliver a breech presentation vaginally and transverse presentation cannot be delivered vaginally.
- Medical Conditions- There are certain medical conditions that will not allow for a vaginal delivery such as certain heart conditions, previous uterine surgery and active herpes legion. These will be discussed with your provider ahead of time.
These are the primary reasons I can think of for immediate c-sections. Have you had any experience with these?