C-Section, No Question

Yesterday we talked about c-sections covering what they are. I concluded that they are great when they are needed. Today I want to share situations when a c-section would be absolutely necessary, no questions asked. Some of the information may be a little scary, but I believe it is important for us to be informed about these situations so if it arises during our pregnancies or births, we know that it is necessary for the baby's health and ours and not simply doctors attempting to control a situation.

1. 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. 
2. 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.
3. 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! 
4. 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.
5. 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. 
6. 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?