HealthPartners - Preparing for childbirth

CHAPTER 6 Cesarean Birth

PROLONGED (STALLED) LABOR Prolonged, or stalled, labor is when your cervix doesn’t continue to dilate or efface or your baby doesn’t move into the birth canal during the first or second stages of labor. This can happen for a variety of reasons, including weak contractions, the position of the baby’s head, or a difference between the size of your pelvis and the size of your baby’s head. Patience, augmentation to strengthen your contractions, and trying to change the baby’s position may help. FETAL DISTRESS Fetal distress can happen when a baby isn’t receiving enough oxygen during pregnancy or labor. A fetal monitor can detect this as an abnormal heart rate. Fetal distress may happen if the umbilical cord wraps around your baby’s neck, loops around their body, or becomes caught between their head and your pelvis. If the umbilical cord is in one of these positions, a contraction can pinch the cord and cut off some oxygen to your baby. If this happens, you may receive oxygen through a mask and turn on your side to stop pinching the cord. Your care team may also lower the head of your bed so your feet are higher than your head. Your provider may try using forceps or a vacuum extractor to deliver the baby vaginally. If these efforts are not successful, you may need an emergency cesarean.

Reasons for a Cesarean

SCAN + PLAY A cesarean birth is a major surgery. When you have a cesarean birth, your baby is born through surgical incisions in your abdomen and uterus. You may need a cesarean birth if a vaginal birth is not possible or if there is concern for the safety and health of you and your baby. Regional anesthesia (spinal block, epidural block) that numbs only the lower part of your body allows you to stay awake during a cesarean birth. In an emergency, you may need general anesthesia and be unconscious through the entire procedure. Cesarean births take less than an hour, and your labor partner may be able to stay with you in the operating room. Factors that may require a cesarean birth • Prolonged labor • Fetal distress • The baby’s position • Placenta and cord problems • Medical complications • Multiple births (twins, triplets, etc.)

72 Your Guide to Labor and Birth