Fetal (from the Baby) Reasons For Caesarean Section

DR OLAOMO NOAH. O

Scar from a
Caesarean section

by DR OLAOMO NOAH. O

Nigerians need to be informed about some of the reasons for Caesarean section, most especially this is based on the presentation of the baby. It is not the weakness of the mother alone that necessitates surgery. Here are some reasons arising from the fetus (baby) which might necessitate a Caesarean section:

1. FETAL DISTRESS (DYING BABY)

One of the reasons why a Caesarean section is done is  fetal distress. 

Babies usually don’t die suddenly in the womb or during labour. They usually give warning signs of impending death before they eventually die. Such signs include; reduced fetal kicks (before labour), presence of meconium (baby poopoo) in the water ( liquor), abnormal fetal heartbeat rate ( too high or too low) etc. These signs are pointers to fetal distress. In such instances, a Caesarean section is usually resorted to.

2. BIG BABY (Fetal macrosomia):

When the weight of a baby is more than 4kg, the baby is regarded as big. For most women, a baby weighing at least 4kg will be difficult to deliver naturally. Such babies usually suffer a lot of trauma and complications in the course of delivery. The mother too is prone to having injuries in her genital tract. A lot of such labours usually result in obstruction too. Hence, most doctors will advise most women with macrosomic babies to opt for Caesarean deliveries. 

3. ABNORMAL BABY LIE.

Lie refers to how a baby stays in respect to the mother’s vertebra column. The normal lie at term should be longitudinal. Transverse lie is an example of an abnormal lie. This occurs when the baby is lying across the vertebra column. A woman with a transverse lie will need a Caesarean section. 

4. ABNORMAL BABY’S PRESENTATION.

This refers to the part of the baby in the mother’s pelvis at term (nine months).

Presentation could be 

•cephalic (baby’s head in the pelvis) 

•breech (baby’s buttock in the pelvis)

•shoulder (baby’s shoulder in the pelvis; occurs in transverse lie) and 

•compound presentation (more than one part in the pelvis- like the head and the hand)

• face presentation (When the baby is coming with the face)

• Brow presentation ( when the forehead is the leading part of the baby in the pelvis

The normal presentation for a baby at term should be cephalic.

Other presentations are abnormal and in most cases, a Caesarean section will be needed for a good outcome for the mother and child.

5. ABNORMAL BABY’S POSITION

A baby might be presenting with the head but the position of the head in the pelvis might be abnormal. Such abnormal positions usually lead to difficult deliveries and labour obstruction. 

Such abnormal positions include face to pubis (when the baby’s face is facing the pubic bone). Some women may successfully deliver a baby with face to the pubis.

When next a pregnant woman is scheduled for a Caesarean section, just remember that there are many reasons that necessitates a surgery and like it has been said before, Caesarean section is not evil.

Dr Olaomo Noah Oluwafemi is a Consultant Obstetrician and Gynecologist with a love for writing. His desire is to enhance people’s lifestyle and effect positive change in their health through his writings.

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