In some cases labour does not progress normally or the foetus starts to show signs of distress that can be observed in the foetal ctg.

The baby may be perfectly healthy, but a C-section may be necessary when there are problems during dilation or if the head is not positioned properly and vaginal delivery is impossible.

A C-section is a surgery in which the baby is removed from the uterus through an incision in the abdomen above the pubic hair.

In some cases cesarean is elective, that is, the mother directly opts for a C-section and not a vaginal birth.

The decision to have a C-section can depend on the obstetrician, the site of birth and the mother’s previous deliveries and medical background of woman.

Reasons related to the baby:

• Foetal defects like hydrocephalus and spina bifida.
• Abnormal heart rate in the baby.
• The foetus is in an abnormal position inside the uterus, such as crosswise (transverse) or bottom first (breech).
• Multiple babies in the uterus (triplet and some twin pregnancies).

Reasons related to the mother:

• Serious disease like heart disease, toxemia, pregnancy-associated hypertension.
• Active genital herpes infection.
• Maternal HIV infection.
• Previous uterine surgery, including myomectomy and previous C-sections.

Problems related to the delivery or birth:

• Prolonged or interrupted labour.
• Large baby (macrosomia).
• The baby’s head is too large to pass through mother’s pelvis (cephalopelvic disproportion).
• Problems with the placenta or umbilical cord.
• Cord prolapse (umbilical cord comes through the cervix).
• Placenta attached to an abnormal site (placenta previa) or prematurely separated from uterine wall (placental abruption).