C-section

According to Maternal-child Nursing, Third Edition, by Emily Sloan McKinney, et al., ...

Indications for a cesarean section delivery include, but are not limited to:

dystocia

cephalopelvic disproportion

HTN

maternal diseases such as diabetes, heart disease, cervical cancer

active genital herpes

some previous uterine surgical procedures such as a classical incision C-section

persistent nonreassuring fetal heart rate patterns

prolapsed umbilical cord

fetal malpresentations such as breech or transverse lie

hemorrhagic conditions such as abruptio placentae or placenta previa

Sometimes performed when a vaginal birth may compromise the mother or fetus, and sometimes done as an elective procedure at the mother's request. The risks and benefits should be carefully considered and weighed when choosing which route to take. Several factors play into the increasing use of cesarean births, and not all are medically related. It is likely that  liability concerns sometimes interferes with sound judgment decisions.

Preparations prior to a cesarean birth should include preoperative teaching, signing of consent forms, laboratory studies, ultrasound evaluations, complete assessments including physical, emotional and mental status examinations, and a prior health record to include PMHx, surgical history, contraceptive history, and reproductive history. Immediate preparations will include establishment of intravenous access with a large-bore catheter and a bolus dose of IV fluids to proceed regional anesthesia, urinary catheterization, skin preparations including hair clipping, antimicrobial cleansing, and sterile prep of abdomen, administration of medications to control gastric secretions, nausea, and postoperative pain, positioning for and administration of regional anesthesia (spinal block), grounding for electrocautery, and assembly of a team of personnel to assist in the operative procedures/recovery period and in the care and possible resuscitation of the newborn. Risks include maternal risks such as infection, hemorrhage, UTI/infections, thrombophlebitis/thromboembolism, paralytic ileus, atelectasis, and anesthesia complications and risks for the infant including inadvertent preterm birth, transient tachypnea of the newborn caused by delayed absorption of lung fluid, persistent pulmonary hypertension, and injury such as lacerations, bruising, fractures or other trauma.