Reasons Why a Birthing Person May Need a C-Section

PĒPI Pippa Davy
MĀMĀ Haylee Davy
PHOTOGRAPHY Catherine Smith @catherinesmithphotography

Let’s look at the conditions and situations in which some birthing people may choose to or need to have a C-section to birth their baby.

Why have a caesarean?

A caesarean section (C-section) is a surgical procedure to deliver a baby opposed to a vaginal birth. Around 25% of birthing people in New Zealand have caesarean births, usually because a vaginal birth isn’t possible or because having a caesarean is the safest option for them and their pēpi.

Some are planned in advance and this is called an elective caesarean. A person may be recommended to have an elective caesarean if:

• They have had a C-section before, and they have chosen not to or it is not safe to have a vaginal birth.
• They have placenta previa, a condition where the placenta/whenua is partially or completely covering the opening of the cervix, preventing the baby from being born vaginally.
• They or their baby has a serious medical condition.
• Their baby is in an abnormal presentation, such as transverse (lying sideways) or breech (bottom or feet first instead of head first).
• They have had complications in a previous labour.

An unplanned caesarean is called an emergency caesarean and may occur because:

• The baby’s heart rate is in distress.
• The labour is prolonged, is not progressing/the cervix isn’t dilating.
• The placenta/whenua detaches from the uterine wall (placental abruption), causing excessive bleeding.
• The umbilical cord drops through the cervix into the vagina before the baby (cord prolapse).
• The pregnant person or baby has developed an infection or serious medical complication, such as worsening pre-eclampsia.
• An attempt at an assisted delivery with forceps or ventouse has been unsuccessful.

Just because you’ve had a C-section before, doesn’t mean you’ll definitely need to have one again. Seven in 10 people who attempt a vaginal birth after caesarean (VBAC) in New Zealand will be successful.

What are the risks of having a caesarean?

According to the New Zealand College of Midwives, the risks of a C-section are as follows: Blood clots, anaesthetic complications, increased blood loss (haemorrhage), wound infection and increased risk during future pregnancies. For the baby, there is a risk of accidental injury during the operation and an increased risk of the baby developing breathing issues.