Cesarean Section

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A Cesarean Section is the delivery of a baby through an incision in the mother's abdomen. The name is apparently derived from an ancient Roman law, Lex caesarea, requiring dying women to be operated on in the last weeks of pregnancy in an effort to save the child- and not, as commonly believed, from the method of Julius Caesar's birth.

A cesarean section is usually performed because the mother's pelvis is too small to allow the baby's head to pass through it, as would occur during normal delivery. Although a cesarean section may be performed before the mother's labor pains begin, it is more often done after she has had pain for several hours and it has been shown that the baby's head cannot descend. This waiting period is known as a "test of labor." Other reasons for performing a cesarean section include severe hemorrhaging from the uterus, an abnormal positioning of the baby, or high blood pressure or diabetes in the mother.

There is great controversy among doctors about how to deliver subsequent babies after a woman's first child has been delivered by cesarean section. If the reason for the first operation was a too-small pelvis, then all later deliveries of normal-sized babies must be by cesarean. But many doctors give a test of labor after a woman has had a cesarean for reasons other than a too-small pelvis. The chief danger of a test of labor under these conditions is the possibility of a ruptured uterus. Although this danger is slight for the mother, it may be serious for the baby.

In choosing the appropriate time to perform the second cesarean section, it is important to make sure that the baby is developed enough to survive after birth. This may be determined through X rays, but it is considered best to wait for labor pains to begin or for the membranes surrounding the baby to break spontaneously. At that time the physician may decide to have a test of labor or to perform the cesarean. If the delivery promises to be easy, the baby should be permitted to come through the natural passages.

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