We have just published Module 6 of the slide set, VBAC- A Safe Alternative to Cesarean Section. The Four Main Reasons for a First Cesarean includes comprehensive information about the four most common reasons for performing a primary cesarean. Download Module 6 as a pdf. It’s free.

These are the four main reasons for performing a primary cesarean:

• Failure to progress/non-progressing labor.
• Abnormal fetal heart rate tracings.
• Malpresentation, breech.
• Macrosomia, “big” baby.

The number of low-risk women who have a primary cesarean for these four reasons varies as much as 10-fold across hospitals in the United States, from 7.1 to 69.9 percent.

Research shows that physician practice style—rather than a laboring person’s health condition—accounts for the wide regional variation of primary cesareans, from 23 to nearly 40 percent.

Leaders in maternity care say that sometimes a cesarean can be avoided when any of these four indications are present. Planning a VBAC is a reasonable option if that is what expectant parents choose.

Module 6 will help you understand what the evidence says about whether or not a cesarean is a solution to each of these indications. You can learn about other options available to you and what you can do this time to avoid a cesarean. There is also a list of helpful questions to ask your caregivers and interactive resources for additional information and support.

You can do things differently this time if you had a cesarean for “failure” to progress, abnormal fetal heart rate tracings, a “big” baby, or a breech.

Reference

American College of Obstetricians and Gynecologists, et al. (2014). Safe prevention of the primary cesarean delivery. American Journal of Obstetrics & Gynecology, 210(3), 179–193. doi: 10.1016/j.ajog.2014.01.026